Health Site’s Woes Could Dissuade Vital Enrollee: the Young and Healthy

The economists and policy wonks behind the Affordable Care Act worry that the technical problems bedeviling the federal portal could become much more than an inconvenience. If applicants decide to put off or give up on buying coverage, rising prices and even a destabilized insurance market could result.

The enrollment of young people is vital for the health care law -- and, for that matter, the entire health care system -- to work. Younger people, who tend to have very low anticipated medical costs, are supposed to help pay for the medical costs of older or sicker enrollees. Without them, so-called risk pools in Ohio and other states might become too risky, forcing insurers to raise premiums. Those higher premiums could dissuade more of the young and healthy from signing up, forcing insurers to raise prices again. Economists call the process “adverse selection” and warn that in its worst iteration it could lead to a “death spiral” of falling enrollment and climbing prices.