Health exchanges go live, but will the young and healthy sign up?

Young people performing yoga exercises.

Brandon Rivera at work in downtown Philadelphia.

It’s October 1, this morning the new Affordable Care Act health exchanges go live. Beginning at 8 o’clock Tuesday morning consumers around the country can start to shop for insurance online at healthcare.govThe success of Obamacare, in part, rests on the ability to attract young, healthy inexpensive people to the insurance market.

They’re called ‘young invincibles.’

People like Brandon Rivera who works at a cupcake shop in downtown Philadelphia. At 22, he is fit and healthy and exactly the type of young person health officials hope to sign up for Obamacare. The administration is counting on them to make the whole thing work by balancing out all the sick people who are expected to sign up.

There’s just one thing.

“I don’t really know much about Obamacare at all,” says Rivera. “I’ve heard the name, but not anything that has to do with it.”

Rivera has plenty of company. A Kaiser Family Foundation poll out this week found nearly 75 percent of the uninsured don’t know the exchanges open for enrollment today.

Rivera gets the importance of coverage. He lives in Camden, one of the most violent and impoverished cities in the nation.

“The nightmare scenario would be like an accident like I could be walking down the street and get jumped, need to go to the hospital and I can’t because of no insurance,” he says.

Rivera, who works full-time at the bakery -- has only been to the doctor once in the last three years. The only reason he went -- his mother made him.

“I went to the emergency room. And the bill ended up like coming to $1000,” he says.

Rivera was on the hook for half the bill and the hospital ate the rest.

And there’s the problem. Rivera gets sick once in three years, and it costs him $500. It’s not clear yet what it would cost him on an exchange but it’s probably more than that. That’s why getting the 'young invincible' is such a tough sell.

“I just basically want to know like how can it cover me, what are my options, how much does it cost,” he says. “Financially that’s the most important thing.”

Even paying the small financial penalty under Obamacare is cheaper than buying coverage. The thing is -- it’s going to take about 3 million young and healthy people signing up to keep insurance costs down for everyone else on the exchanges.

About the author

Dan Gorenstein is the senior reporter for Marketplace’s Health Desk. You can follow him on Twitter @dmgorenstein.

Brandon Rivera at work in downtown Philadelphia.

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