Some who are young and healthy don't think they need medical insurance. More than expected paid the fine for not having insurance. Now that the fine is lifted, some of those who purchased health insurance will drop it and gamble they will stay in good health, since the effective cost of the insurance has increased.

Of course, Ryan is bypassing the likelihood that a shift to an age-based tax credit from an income-based subsidy will mean some poorer, "younger" people will receive less money, and will be even more likely to gamble, or may simply be unable to afford insurance even if they know they need it.