By Amanda Sounart, associate editor
With youth comes a certain sense of invincibility. Most young adults under 30 have yet to face chronic disease or disability. While many of them appreciate the safety net that health insurance provides, it is often priced higher than they can afford, meaning food and rent may take priority over the possible need for prescriptions and doctor visits.
They take the chance that they will remain healthy.
“For many young people, healthcare is just too expensive,” said Julius Hobson, a senior policy advisor at Bryan Cave LLP and previous director for Division of Congressional Affairs for the American Medical Association. “Either they don’t have access through their employer or they can’t afford it. In many instances the attitude is ‘I’m not sick, so I don’t need it.’ They don’t think it’s a problem until they get ill.”
When illness or injury does occur, even the healthiest of young adults have to turn to medical professionals for help.
Twenty-nine-year-old Christina Buckner of El Cajon, California, has been without health insurance since 2005, when she left a large company to work for a small business that didn’t offer coverage. Her husband, also 29, is without company-sponsored insurance, as well. Buckner and her husband could not afford private insurance but were willing to live without it until last year when Buckner became pregnant.
Knowing that she needed prenatal care, Buckner searched private and public health insurance plans, looking for something that they could afford.
“I spent hours looking for coverage, but no company would take me because my pregnancy was considered a pre-existing condition,” Buckner explained. “It was so stressful searching for it, especially since it was early in my pregnancy and I needed to get prenatal care as soon as possible.”
During her first trimester, while still uninsured, Buckner developed complications and needed immediate medical attention. It was then that she discovered living without insurance could be deadly.
“No doctor would see me. I couldn’t even get into urgent care clinics,” recalls Buckner. “I was driving around, sick, bleeding, making calls to different doctors’ offices. I was scared. I was afraid to go to the emergency room because we couldn’t afford it, but I didn’t know what else to do. Fortunately, my mother’s friend, who is a doctor, agreed to see me. If he hadn’t treated me when he did, I would have had a miscarriage.”
While Buckner was able to find care outside of the emergency room, many young adults turn to the one place where they can receive care, whether or not they can afford it.
“When [young adults] become ill, they show up where the care is most expensive, and that’s in the emergency room,” noted Hobson. “A lot of the time, they’re not doing regular checkups. Then when they have a health problem, they go to the emergency room, and that is where care costs the most.”
After nearly losing her unborn child, Buckner was able to find health insurance through Access for Infants and Mothers (AIM), a state-funded program designed to cover prenatal care for middle-income expectant mothers. Buckner’s coverage ended four months after delivery. Her 7-month-old son is now covered through Healthy Families, the California State Children’s Health Insurance Program (SCHIP).
“We pay very little monthly for Healthy Families, and my son is covered,” said Buckner. “But you can only be in a certain financial bracket. If we were to make more money we would probably lose his insurance.”
This young family is not alone in their search for health coverage. A survey from the Commonwealth Fund estimated that there are approximately 13.2 million uninsured young adults in the United States. While this age bracket only accounts for 18 percent of the population, it comprises nearly 28 percent of the country’s 47 million uninsured.
With the current recession, the number of uninsured is expected to grow. A report in Health Affairs notes that the increasing unemployment rate coupled with the rising cost of insurance could elevate the total number of uninsured Americans to 52 million by 2010.
Many young adults go without insurance because they fall into one of several gaps in the current healthcare system. Most insurance policies terminate coverage for dependents at age 19 or upon their completion of college. Without their parents’ insurance, young adults are left to find their own coverage.
Over half of young adults have incomes 200 percent below the federal poverty level, according to the Urban Institute report, yet only 13 percent of them are eligible for Medicaid or other public programs that provide medical coverage.
Although Buckner was able to find coverage during her pregnancy, she, like many young adults without coverage, worries about the future.
“The only one of us that’s covered is my son,” noted Buckner. “If anything were to happen to my husband or me, we’d be in dire straights. We couldn’t afford the ramifications, that is, all the medical bills.”
Whether coverage was terminated under a dependant plan or health benefits were not offered through an employer, young adults face a number of obstacles in obtaining medical coverage as the number of uninsured continues to grow.
In response to the growing number of uninsured, especially those under 30, President Obama has made insurance coverage a central focus of health care reform plans and has urged Congress to take immediate action to address reform.
“This is an issue that affects the health and financial well-being of every single American and the stability of our entire economy,” Obama said in a weekly address. “It’s about every family unable to keep up with soaring out of pocket costs and premiums rising three times faster than wages. Every worker afraid of losing health insurance if they lose their job, or change jobs. Everyone who’s worried that they may not be able to get insurance or change insurance if someone in their family has a pre-existing condition.”
As the Senate and House of Representatives continue to look over proposals for health care and insurance reform, young people can check with their state to see if an increase in the age of dependency coverage has been put in place.
According to the National Conference of State Legislatures, at least 30 states have enacted legislation that extends the age of dependent coverage, regardless of enrollment in school. And many states have enacted provisions to extend the age of eligibility to 25 or 26, with some states, including Florida and New Jersey, allow individuals up to the age of 30 to remain on health insurance plans as dependents.
Young and Uninsured: By the Numbers
For many young people, health insurance is more than they can afford. Here are a few of the statistics on the young and uninsured in the U.S.
- People in their 20s make up 29 percent of the uninsured in America
- One in three adults aged 19-26 are uninsured
- Only 13 percent of uninsured young adults are eligible for Medicaid
- Approximately 28 percent of the young uninsured has the option of employer sponsored insurance
- Forty-eight percent of uninsured young adults believe they need health coverage
Source: J. Holahan and G. Kenney, “Health Insurance Coverage of Young Adults: Issues and Broader Considerations,” June 2008
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