health-care-moneyWith health-care reform advancing through the halls of Congress, a group vital to President Barack Obama’s election – young adults – have become a major beneficiary of his biggest domestic priority; they are also likely to play a big role in funding any reform lawmakers pass. Last year, a study from the Urban Institute concluded that over 10 million Americans aged 19 to 26 have no health insurance coverage. For many of them, health-care reform offers the hope of inexpensive policies, which are unavailable today in many states. But there’s a trade-off: young adults wouldn’t be allowed to wager on their good health any longer, since all the bills before Congress require individuals to buy at least the bare minimum of coverage. The survival of any form of “universal” coverage depends on the participation of young adults: because they are low-cost additions into insurance pools, they would help thin the costs of covering older people, who are likely to be sicker. Depending upon the requirements Congress imposes upon insurers to price their coverage these young adults may wind up paying wildly large premiums, in effect subsidizing the coverage for their parents’ generation. This group is uninsured for a variety of reasons: they are more likely to work for employers who don’t offer coverage; they might not qualify for public assistance like Medicaid; credit card payments, student loans and other debt may mean that even the barest coverage offered by private insurance plans may be too expensive. And some young people, who are nicknamed the “young invincibles,” are likelier to assume they won’t need health coverage, or decide they’d rather spend the money on other things. To discourage this attitude, the Senate Finance Committee bill would penalize individuals who don’t purchase coverage. One early draft set the fine at $750 or $950 per year for single people, based upon income. But even the least expensive coverage under the proposal could cost over $100 a month, which means it would be cheaper to pay the fine than buy the insurance. It’s essential that young, healthy people take part, because requiring people to have coverage is really a mechanism for financing health-care reform. The more individuals who are steered to the system through such a requirement, the lower the total cost of subsidies the government has to provide to keep coverage affordable. If young adults fall through the cracks, or if Congress, under political pressure, provides too many exemptions from participating, the government and the people who buy insurance will see higher costs. One group that could potentially be squeezed by reform is young adults who have health problems, with incomes that aren’t high enough to afford the expensive coverage they may require to manage chronic conditions. Young adults are routinely rejected by insurance companies for having preexisting conditions. According to a Washington Post-ABC News poll, around 52% of young adults support the idea of an individual mandate; that’s about the same proportion among other age groups. In terms of the overall package, the under-30 group strongly supports the Democrats’ effort: 60% of them favor the proposed reforms, vs. 42% among older adults. And although the number is down from its peak, 63% of under-30s say they approve of President Obama’s overall job performance, significantly more than other age groups. Given the implications of reform and its costs, advocates for young adults question why they haven’t drawn special attention from Congress and the White House in the same way union members, seniors, and others have. – Boomer