While Hillary Clinton is struggling to get young people — the ones who helped elect Barack Obama twice — to the polls this year, the outgoing president is having trouble getting these same people to sign up for health insurance.

Much of the Affordable Care Act’s struggles are tied to the fact that millions of millennials are forgoing insurance. As a result, the ACA marketplace is older and sicker than anticipated, making it hard for insurers to turn a profit. In response, insurers have been raising premiums or leaving the marketplace entirely.

Currently, young people account for roughly 30 percent of ACA plan policyholders. The administration would like to see that figure rise to 40 percent, but that goal appears increasingly unrealistic.

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