The reason to force young people to buy health insurance under the Affordable Care Act (ACA) was because they are an easy profit center. They won't use much in the early years but they will when they are old, when a new generation of young people will be forced to pay.

It hasn't really worked out that way. While emergency room visits did go down slightly, visits were instead done more in an office for the difference, the cost of mental illness ER visits in this age group increased "significantly," as did diseases of the circulatory system, according to a paper in Annals of Emergency Medicine.

Researchers conducted a before and after study of patient visits to emergency departments in California, Florida and New York to determine whether the ACA had an impact on those visits. Patients age 19 to 25 were compared to patients 26 to 31 over the same time periods (September 2009 through August 2010 versus January through December 2011).

After the implementation of the ACA, the rate of emergency department visits by young people decreased by 0.5 percent. However, the relative risk of a young adult ever to visit the emergency department increased by 2.6 percent for mental illness and by 4.8 percent for diseases of the circulatory system (e.g. cardiac dysrhythmias). The relative rate of emergency department visits decreased by 3.7 percent for pregnancy-related diagnoses and by 3.3 percent for diseases of the skin (e.g. cellulitis and abscesses). The decreases in emergency department visits were seen almost exclusively among white and black young adults, not Hispanics.

"The troubling finding is that young adults were more likely to visit the emergency department for mental illnesses following expanded insurance coverage under the ACA," said study author Renee Hsia, MD, of the University of California San Francisco. It may be that the administration needs to invest in more safe spaces.