The clock is ticking towards October 1, 2013 when public insurance exchanges are set to go live and begin offering health plan benefits to an estimated 30 million previously uninsured Americans. And as that day draws closer, all parties involved—plans, providers, employers, and patients—are scrambling to figure out just what it will mean to them from a cost and quality of care perspective. Yet, perhaps one of the biggest conundrums associated with the health insurance marketplace is how to deal with the potential sticker shock facing younger Americans and the ripple effect it could have on everyone. Specifically, with an age band as narrow as 3:1, there is a possibility that premiums for younger people (who tend to be lighter users of service) will be considerably higher in order to compensate for older Americans, who typically utilize more health care services. When combined with a relatively low penalty for not getting coverage, there is a very real fear that many of these ‘young invincibles’ will forgo coverage and simply choose to pay the penalty.