Base health insurance pricing on utilization not age to create healthier behaviors. Our society wants instant gratification…give me a pill that will get rid of the symptoms. They don’t want to put in the work to correct the underlying problems. I am a licensed insurance agent and pricing is based on age not utilization so a 50-60 YO is going to pay $800-1000 per month for coverage and a 20-30 YO is going to pay $300-400 per month. As a healthy 64 YO I’m paying $1200/mo for a HDHP and haven’t used it in over 12 years except for preventative check ups. Younger unhealthy individuals pay far less and incur far more claims than premiums they pay so the system isn’t balanced and there is no incentive to encourage healthier behaviors.
The Marketplace provides subsidy which is abused giving the individuals Platinum plans that don’t require any contribution, copays or deductible in many cases so they over utilize services for every little sniffle. The IRS isn’t checking subsidy against 1094 filings as I have employees tell me every day they are on the marketplace and accepting subsidy even after I inform them they don’t qualify because their employer is required to provide ACA coverage and their cost falls within the affordability guidelines and they still decline and stay on marketplace and accept subsidy.