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July 6, 2013

Health insurers fear young people will opt out

MIAMI (AP) — Dan Lopez rarely gets sick and hasn’t been to a doctor in 10 years, so buying health insurance feels like a waste of money.

Even after the federal health overhaul takes full effect next year, the 24-year-old said he will probably decide to pay the $100 penalty for those who skirt the law’s requirement that all Americans purchase coverage.

“I don’t feel I should pay for something I don’t use,” said the Milwaukee resident, who makes about $48,000 a year working two part-time jobs.

Because he makes too much to qualify for government subsidies, Lopez would pay a premium of about $3,000 a year if he chose to buy health insurance.

“I shouldn’t be penalized for having good health,” he said.

Persuading young, healthy adults such as Lopez to buy insurance under the Affordable Care Act is becoming a major concern for insurance companies as they scramble to comply with the law, which prohibits them from denying coverage because of pre-existing conditions and limits what they can charge to older policy holders.

Experts warn a lot of these so-called “young invincibles” could opt to pay the fine instead of spending hundreds or thousands of dollars each year on insurance premiums. If enough young adults avoid the new insurance marketplace, it could throw off the entire equilibrium of the Affordable Care Act. Insurers are betting on the business of that group to offset the higher costs they will incur for older, sicker beneficiaries.

The nonpartisan Congressional Budget Office estimates that about six million people of various ages will pay the tax penalty for not having insurance in 2014, the first year the law championed by President Barack Obama will be fully implemented.

It’s hard to estimate how many of those will be the young and healthy adults insurers are trying to reach, but that subgroup makes up a very small portion of the overall market. Even though it’s small, experts say it could be enough to throw the system’s financing off-kilter.

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