Melissa Maynard was a GOVERNING contributor, working as a project reporter on the Government Performance Project, a project of the Pew Center on the States.E-mail: firstname.lastname@example.org
Young adults aren't a politically viable demographic in the health insurance debate, but they comprise the largest uninsured segment of the population. Healthy twentysomethings fretting about the possibility of ruptured appendices draw less sympathy than uninsured children and the ailing (and politically all-important) baby boomers.
New York Magazine recently published a fascinating article about these so-called young invincibles -- who, as it turns out, are not actually all so invincible. Filled with first-hand accounts of credit-ruining brushes with death, the piece reads more like a horror story than a health policy piece.
Part of the problem for young people is the shifting structure of the economy. The job market is less paternalistic than it was 10 years ago and health insurance is much harder to come by in entry-level positions. Ambitious young people are encouraged to job hop instead of sticking with the same company for decades at a time, where they'll be supported for the long haul.
"For the young who don't luck into a job that offers coverage, a certain outlook becomes inevitable: Premiums are a fortune, you can barely pay your rent, you rarely need a doctor, you decide to gamble," Amsden writes. The young uninsured avoid doctors and hospitals until their problems become life-threatening and costly, and then, if they recover, spend the next chunk of their like working their way out of debt. Preventative care isn't an option, and the resulting costs to society are great.
Young adults are better off in states like California and Illinois that allow insurance companies to offer low-cost plans through an "age-banding" system that puts them in a different risk pool than, say, a 60-year-old diabetic with high blood pressure.
Companies such as WellPoint's Tonik can offer premiums for as little as $67 a month because the actual cost of medical care for young adults is so low. The situation is worse in states like New York that require insurance companies to use a community rating system, which throws everyone (young and old, healthy and sick, firm and infirm) into the same pool. The concept of insurance, of course, is to spread out costs among a larger risk pool, but under the current system, twentysomethings are being asked to shoulder too much of the burden.
As a twentysomething myself, I've been seeing the effects of the health insurance issue play out in the lives of my friends, with varying degrees of heartbreak. A friend who was going without insurance while putting herself through college developed a 9-pound uterine cyst and had to have surgery the week before finals, incurring crippling debt. Brilliant journalist, writer and artist friends have been forced to make depressing insurance-driven career moves. They get stuck in jobs they hate, in fields like banking and advertising, where their talents are woefully underutilized.
Whether you're talking about the direct economic costs passed on to the rest of us because of unpaid hospital bills, or the economic stifling caused by debt-ridden youngsters stuck in dead-end jobs, these problems are very real for my generation, however unsexy they may be politically.
Written and compiled by staff writers and editors, GOVERNING View is an on-the-ground, and sometimes behind-the-scenes, look at the topics we're covering in print and online. From notes on what's up in statehouses, county courthouses and city halls, to encounters with people, places and things, GOVERNING View is a window into the side of state and local government you don't always see.