First Lady Michelle Obama, appearing on "The Tonight Show" with Jimmy Fallon, thanked one of the demographic groups that made her First Lady by calling them "knuckleheads." Discussing ObamaCare, Mrs. Obama opined, "A lot of young people think they're invincible. But they truth is young people are knuckleheads. They're the ones who are cooking for the first time and slice their finger open. They're dancing on the bar stool."

This is not the first time Mrs. Obama spoke to the knuckleheads. In 2012, she told supporters, "They should reach out to the 'knuckleheads' in their lives and tell them to vote for Barack Obama." Perhaps its Jimmy Fallon who brings out the knucklehead comments from the Obamas. In 2012, the president described to Jimmy Fallon the Secret Service agents implicated in the Columbian prostitution scandal as, "a couple of knuckleheads."

It turns out that Mrs. Obama's knuckleheads represented 19 percent of the 2012 electorate and voted for her husband by a 60 to 37 margin over Mitt Romney. And in return for their support, their reward is an unemployment rate is over 16 percent. Over one third of this knucklehead group is living at home with their parents. And this is the thanks they get from Mrs. Obama?

ObamaCare needs these knuckleheads to sign up and pay for insurance in order to support healthcare costs for older generations. This is the concept of adverse selection, and name-calling won't overcome the disincentives for millenials to buy health insurance that they neither need nor want. The reality is that the knuckleheads, despite exercising poor judgment in their electoral choices, are not so dimwitted in their financial decisions. Less than one quarter of millenials plan on signing up for ObamaCare, aggravating adverse selection. Thus the reason for the individual mandate requiring everyone to purchase insurance or pay a penalty.

A famous quote, "There's a sucker born every minute" is incorrectly attributed to P.T. Barnum, circus master noted for his side shows and displays of freaks. Mr. Obama is the ringmaster of his own circus, ObamaCare, changing repeatedly like a modern day shape shifter in an endless string of sideshows. The millenials, who bought tickets for Mr. Obama's circus, are walking out as the show is just getting started. Calling them knuckleheads won't get them back in their seats.

Brian C Joondeph, MD, MPS, a Denver based eye surgeon, is an advocate of smaller, more efficient government. Twitter @retinaldoctor.