Almost half of young adults–a group some would argue are the most insurable–went without health coverage for more than one month in 2006 and almost one-fourth, or 3.5 million Americans, were uninsured for the entire year, according to a new federal report.
Authors of the Agency for Healthcare Research and Quality report said this population, ages 19-23, were almost twice as likely to be uninsured all year as adults ages 45–64. The agency compiled the report based on most recent data from the ongoing Medical Expenditure Panel Survey.
Most significantly, nearly one-third of those who had no insurance for an entire year felt health insurance was not worth the cost.
It was not clear from the report how much money the illnesses and injuries in this group of uninsured cost the healthcare system through uncompensated care and how much the patients paid out-of-pocket.
The group is largely healthy, with only 6.5% reporting they'd been diagnosed with any form of chronic condition by a health provider.
But, the authors said, the fact that a disproportionately larger numbers of people in this age bracket are uninsured relative to older groups of adults is cause for concern.
The report, entitled "Characteristics of Uninsured Young Adults: Estimates for the U.S. Civilian Noninstitutionalized Population, 19-23 Years of Age, 2006," was written by Karen Beauregard and Kelly Carper.
Among its other findings:
- Those who were uninsured for the entire year were more than twice as likely to have been unable to obtain necessary healthcare as their insured counterparts.
- Although some insurance companies allow young adults who are students to be covered on their parents' health insurance policy until they are 23, only 18.5% were enrolled and eligible under this provision. However, of those young adults who were uninsured for the whole year, 18.6% were full-time students in contrast to 42.2% of those who had health insurance for some portion of the year, indicating that some students were able to take advantage of their parents' policies.
- Hispanics were more than twice as likely to have no health insurance for the entire year (43.9%) than black non-Hispanics (21.1%) and whites (19%).
- The lower the level of education attained, the more likely a young adult was to have no health coverage through the year, with 30.6% who had not graduated from high school, compared to 15.5% of those who had at least some college.
- Males were more likely to be uninsured for the entire year (29.8%) than females (17.9%).
Joel Cohen, director of the division of Social and Economic Research for the AHRQ, suggested that females tend to not lack health coverage as much as males because in many cases, they are eligible for programs like Medicaid.
He added that in many cases, individuals within this age bracket work in settings that offer health coverage, but "it may not be considered affordable by the workers, so they may not sign up."
A spokesman for America's Health Insurance Plans, Robert Zirkelbach, says many health plans have devised policies to meet specific pricing and insurance needs of young adults. However, he says, "Certainly, there's a recognition that many young adults simply don't choose to participate."
As policymakers design comprehensive healthcare reform legislation in Washington, Zierkelbach says they need to require that all people participate in the healthcare system. This would mean that all Americans, including individuals between the ages of 19 and 23, would have to sign up, though the federal government could provide subsidies through tax breaks to help with the cost of premiums.
The insurance industry will do its part, he says, by guaranteeing coverage for pre-existing conditions and no longer performing health status ratings for its applicants. "But for that to work, there needs to be a personal coverage requirement to get everybody into the system."
He adds that price differentials would still exist based on an applicant's age, geographic residence, family size, and the design of the benefit plan.