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Why The Youth Gap On Obamacare Exchanges Could Be A Yawner

The dust is settling a bit after the administration released details Monday about who signed up for health insurance on the exchanges during the chaotic three months after they launched Oct. 1.

Just about everybody was watching to see how many young people piled in. Younger people are generally healthier, and their premiums tend to balance out insurers' outlays for older, sicker people.

For Obamacare to work over the long haul, young people need to be a big part of the health insurance mix.

The administration ultimately hopes that about 40 percent of the people who get insurance through the exchanges will be young adults.

As the year wound down, lots of people enrolled. Many of them were young, but people ages 18 to 34 came in at just 24 percent of the total sign-ups.

Big deal? Maybe. Maybe not.

"Had we seen the numbers reversed, with strong young-people enrollment, that would have been a surprise," says Matthew Eyles, an executive vice president at Avalere Health.

But the relatively low turnout of young people for coverage isn't a shock.

People in generally good health will probably wait to sign up, unless there's some particular medical care they've been waiting for, Eyles tells Shots.

"Age is a very good proxy for health spending," he says, though it's not perfect. It's possible, for instance, that health problems provided the motivation that many young people, and older people for that matter, needed to slog through the early problems with and some states' exchanges.

So the key piece of info that would be good to know is how healthy are the people who signed up for insurance at the start. "We don't have actual health information for the early enrollees," Eyles says.

Even so, the early returns are fairly encouraging, he says. People put off making insurance decisions. That was true when Medicare added a drug benefit, he said.

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