A few things: First, the denominator of 50 million is incorrect. Between 2.3 and 2.9 million young adults gained coverage through the ACA’s young adult provision. That is the denominator we’re working with (some young adults already had insurance; some still don’t; others gained it but not through the young adult provision). But more importantly, your comment seems to rest upon the assumption that all of those young adults were going to die during young adulthood, which of course is not correct. This is a population with a very low mortality rate, particularly from chronic disease. To see a decline in disease-related mortality among this age group in the short study period is quite remarkable, given that the benefits of preventive care usually take time to accumulate. The observed decline in disease-attributable mortality indicates that many more young adults are accessing medical care and reaping the preventive benefits; reduced mortality, in this sense, is a proxy variable for better healthcare access and improved health. In the long-term, shifting towards preventive medicine from an early age is the only way we will reduce healthcare costs in the country. Reactive medicine will never work as a healthcare model.