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.

The administration has tried a number of different tactics to compel millennials to enroll. It has raised the penalty for going without insurance every year of the ACA’s existence so far; it now is $695 for an individual, up from only $95 in 2014.

The current effort that is directed specifically at young people is a massive advertising campaign focused on social media networks and websites frequented by young people, as well as in movie theaters. Lyft, the ridesharing service, has agreed to offer free rides to ACA sign-up events during the upcoming open enrollment period that begins on Nov. 1.

That messaging will be supplemented by appeals from the president himself, who will give an address at the University of South Florida on Wednesday in which he will urge young people to take ownership of the landmark health law to help it survive.

While young people have always been less likely to be insured since they have less money and fewer health concerns, experts believe that many more would sign up if they understood the subsidies they are eligible for. Politico reports that most enrollees could find a plan for less than $75 a month, after subsidies. 

Many who are forgoing plans out of fear of the cost might only be saving themselves a couple hundred dollars a year, since they will be subject to the nearly $700 fine for not having coverage.