By Kimberly Leonard

The “young invincibles” live up to their name. They don’t think they’ll get sick or hurt, and so they take bigger risks than most people, including the risk of going without health insurance. Because of this, they have posed a challenge for insurers and the Obama administration.

Young, healthy Americans are a crucial demographic to the success of the Affordable Care Act. Their participation in Obamacare exchanges is important to help balance out the cost of older enrollees more likely to get sick and need medical care more often.

The White House has a challenge ahead, both for this year’s open enrollment and the long-term sustainability of the law. Without enough enrollees, health insurance companies leave the exchanges, which often results in cost increases and fewer options for medical care.

Here are some key things to understand about this demographic group, and what proposed strategies exist to nudge them into Obamacare:

1. The group in question is between the ages of 26-34.

Why not younger? Don’t 21-year-olds tend to consider themselves invincible? Yes, but the difference is that, under Obamacare, anyone under age 26 has the option of being covered by their parents’ plans (if the parent has insurance through an employer or an exchange plan). White House officials often tout how Obamacare halved the uninsurance rate among 18- to 26-year-olds, but omit this key reason why. This is important to keep in mind in reporting on enrollees that are difficult for Obamacare to reach, because the younger demographic has less at stake if they are getting insurance through a parent. It is easier than paying into a policy every month.

The Department of Health and Human Services has encouraged insurers to contact young people when they turn 26 to tell them how they can enroll in a health care plan on the exchange. Most people have to sign up for health insurance during open enrollment, but this group qualifies for a special enrollment period.

2. We know young, healthy enrollees are a big part of the remaining uninsured.

Since the Affordable Care Act became law, more than 20 million people are covered by health insurance, but 27 million others remain uninsured. Of these, 27 percent of the are younger than 30, and 68 percent have low health risks, according to consultant McKinsey & Company data provided by the Department of Health and Human Services.

The Obama administration has tried to help young people understand the importance of getting insurance, including telling them that it protects against catastrophic costs from an accident or serious illness and helps them continue their education.

This year, the Department of Health and Human Services is planning a more aggressive email campaign with this group, including emailing them if they open an account but don’t start an application, start to apply but don’t finish or select a plan but not pay the premium.

3. The penalty may not a sufficient incentive to get this demographic to pay insurance premiums.

Eighty-five percent of exchange customers receive subsidies for buying insurance, but some still say that the cost of insurance is not affordable.

According to a study by the Commonwealth Fund research group on the remaining uninsured, affordability was cited as a top concern among adults who were aware of the exchanges or who have tried to enroll for coverage. A health insurance plan is considered “affordable” if it comprises 9.66 percent of a person’s income or less, but to a person with many other payments to make – such as student or housing loans, childcare payments and other fees – the amount may be prohibitive.

For some – particularly healthy young people – a $695 per-person penalty may not be enough incentive to buy insurance. Even if subsidized premiums total as little as $75 a month (as many do), the plan may come with some unexpected high costs, such as a $7,000 deductible.

Changing the penalty amount would have required Congress to change the law before open enrollment begins. That likely was an unrealistic expectation, with an election looming and widespread Republican opposition to the law in the first place.

Consulting firm Avalere Health has suggested that young people could be recruited more easily if they saw some benefits they could use upfront (such as coverage for contact lenses or glasses), or if the subsidies were restructured so young people could better benefit.

4. Medicaid expansion also affects this group.

The Affordable Care Act originally was written to have all states expand Medicaid to cover anyone making less than $16,243 a year for an individual. Several governors contested the law, however, and in 2012 the Supreme Court ruled that states could decide whether they wanted to participate in the program. At this time, officials in 19 states still refuse to expand the program, so their low-income young adult residents can’t access Medicaid. They do not have to pay the penalty, however, if they qualify for neither Medicaid nor exchange plans.

5. The Obama administration is leveraging technology to reach this group.

For 2017 open enrollment, the Department of Health and Human Services is partnering with private companies or associations, including:

• Lyft: The ride-sharing service is developing user discount codes for customers to take Lyft to open enrollment events where they can get help signing up for coverage. Their drivers in 190 cities will also find ways to remind people of enrollment deadlines and why they should get coverage.

• American Hospital Association: The hospital group is creating a social media toolkit for members to educate young adults in their communities on how to get subsidized insurance on the exchange.

• Enroll America, Young Invincible and Out2Enroll and 75 partnering organizations are announcing four targeted campaigns for open enrollment, aimed at young adults, community college students, young families and LGBTQ youth.

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Kimberly Leonard (@leonardkl) is a health care reporter for U.S. News & World Report and a co-chairperson of the AHCJ chapter in Washington, DC.