Why is hard to understand that a healthy person who pays $6,000 a year into the insurance system is more helpful to its finances than a healthy person who pays $2,000 a year? That is the basic story when it comes to older people in the exchanges (ages 55-64) and younger people. The average premium for this older group is three times as much as for the younger group. Large portions of both age groups will require little or no health care services over the course of a year.

This is why it makes relatively little difference if the exchanges have a skewing of enrollees by age, as a Kaiser report showed last year. It does matter hugely if there is a skewing by health condition with only less healthy people signing up. This is why it is annoying to see the Post once again tell readers:

"If not enough young and healthy people sign up on the federal and state insurance marketplaces, that could lead to a cycle of increasing premiums and decreasing enrollment, or what some call a 'death spiral.'"

The word "young" just takes up space and makes the article less accurate. The program could face a death spiral if enough healthy people do not sign up. It doesn't matter whether or not they are young.

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