How Will They Use Their Power? Without the enrollment of healthy young millennials, the insurance pool of total participants in the exchanges set up by the Affordable Care Act will contain only older and sicker Americans, and so the price of health insurance premiums will inevitably rise. Millennials, then, can sink or float the boat. Yet a recent Harvard's Institute of Politics (IOP) survey found that among the 18 to 29-year-olds who currently lack health insurance, less than one-third say they're likely to enroll in the exchange. From October 30 to November 11, the IOP surveyed 2,089 young adults between the ages of 18 and 29. When discussing the health care reform bill signed into law in 2010, IOP split the sample and identified it as the "Affordable Care Act (ACA) " for 1,024 respondents, while using the term "Obamacare" for the remaining 1,065 respondents. About 22 percent of the millennials surveyed currently lack health insurance; of these currently uninsured young adults, 29 percent (13 percent definitely will enroll, 16 percent probably will enroll) reported they will enroll in Obamacare, while 25 percent (10 percent definitely will enroll, 15 percent probably will enroll) gave the same answer when pollsters referred to the program as the Affordable Care Act. These numbers, a recent Gallup survey found, are much the same when the demographics are broadened to include older adults. Under the new law, adults are permitted to remain on their parents' health care insurance until the age of 26. At that point, the individual mandate goes into effect; under health care reform, all eligible Americans are required to carry at least basic health coverage. Those who are uninsured and choose not to sign up for health insurance will pay a fee. This individual shared responsibility fee, as it is sometimes referred, goes into effect beginning January 1, 2014. For each month an individual lacks health insurance, a penalty will be applied to annual taxable income - $95 per adult and $47.50 per child, or one percent of total taxable income (up to $285 for a family), or whichever is greater. Although subsidies will be provided for those below the poverty level, in practice many people may be required to pay thousands each year for a health care plan under the exchanges, so in some cases the penalty simply costs less. Gallup estimates that, currently, about 17 percent of all U.S. adults, nearly one in six, do not have health insurance. In their recent interview of 4,000 uninsured American adults, the global polling firm found that 28 percent say they are more likely to pay the government fine rather than purchase insurance on the exchange. This poll was conducted between November 20 and December 2. Of those choosing to pay the fine, men edge out women, with 31 percent as compared to 25 percent saying they prefer paying a fine, while those over 30 are somewhat more likely (30 percent) than those under that age (26 percent) to pay the fine than enroll. Geographically, the highest percent of intended non-participants reside in the Midwest (34 percent) as compared to the South (29), the East (27) and the West (26). The employed are more likely to pay a fine than enroll (30 percent versus 25 percent). Finally, and worst of all, a full 29 percent of those who are parents of children under 18 say they will be paying a fine, compared to 28 percent of those who are not parents of dependent children. "With 28 percent of the uninsured group not planning to get insurance, assuming they follow through on those intentions, that would mean a minimum of five percent of all U.S. adults would be uninsured, leaving the U.S. short of its goal of universal coverage," Jeffrey M. Jones reported on behalf of Gallup. Returning to the opinions of younger Americans, when the IOP survey asked whether they approve or disapprove of the health reform law, most millennials disapprove. Referred to as the Affordable Care Act, 39 percent approved and 56 percent disapproved with nearly identical numbers reported - 38 percent and 57 percent, respectively - when the term Obamacare was used. Between 50 (when ACA was used) and 51 percent (when Obamacare was used) suppose their health care costs will likely increase under the new law, while only 10 percent (ACA) and 11 percent (Obamacare) reported they expect their costs will decrease. When asked about quality of health care, the survey results appear even more dismal. By either name, most under-30 adults believe quality under the new health care reform bill will decline; 40 to 44 percent expect their care to worsen, while only 17 to 18 percent expect to see improvements. "The reasons for the current lack of support among millennials for the Affordable Care Act are many, and few are surprising given the trends that our polling has revealed for the better part of the last four years," Harvard Institute of Politics Polling Director John Della Volpe stated press release. Young Americans hold the president, Congress, and the federal government in less esteem almost by the day, and the levels of engagement they are having in politics are also on the decline.