Ten Miles Square


June 12, 2012 11:40 AM Young Adults and Health Insurance

By Don Taylor

Sarah Kliff highlights a study from Commonwealth that finds 2 in 5 young adults (age 18-29) reported a cost-related barrier to receiving health care in the past year. Her main point is that the so-called “young invincibles” are apparently not as invincible as they think.

Tangentially related is United Health Care’s announcement recently that the company will continue to allow young adults up to age 26 to be covered by their parent’s health insurance regardless of the outcome of the Supreme Court case on the constitutionality of the Affordable Care Act. In one sense, this is good news from a coverage expansion perspective; it simply maintains another route to coverage in our Rube Goldberg system of providing health insurance that is insulated from what the SCOTUS may rule. There would be fewer covered today without this provision, and for that, I am glad. However, this aspect of the ACA (the ability of a person up to age 26 to get health insurance from their parent’s job, even if they are not in school or are married) strikes me as one of the clearest examples of how much work is left to be done even if the ACA is implemented exactly as passed.

That provision has always stuck in my craw as simply not making sense, not on technical grounds, but on what it says about our nation’s inability to put together a system that makes sense. For some reason, I associate it with my nephew who served in the Marine Corps, and who did two tours in Afghanistan by the time he was 22. If you are old enough to go to war, it seems that you are old enough to obtain health insurance some way other than your parent’s job.

We need to develop a straightforward means of providing health insurance coverage to all young adults, that makes sense in light of the transitional nature of that age, and the epidemiology of health care needs and use at this age. There is much to be done regardless of the SCOTUS ruling.

[Cross-posted at The Reality-based Community]

Don Taylor is an associate professor of public policy at Duke University, where his teaching and research focuses on health policy.


  • jjm on June 12, 2012 12:27 PM:

    Well, Mitt Romney has just confirmed that he would get rid of the 'pre-existing conditions' rule in the ACA.

    As far as young people getting coverage other than through their parents' plans: have you known a young person who was actually given coverage once they applied?

    My son had one asthma attack in college and he was DENIED everywhere. I would bet that your nephew, after two tours in Afghanistan, would provide some excuse for the insurers not to bet on him: did he suffer a single wound? Might he have PTSD? For pete's sake, we don't want to have HIM on our rolls.

    The CEOs of insurance companies want your money so that they can 'invest' in derivatives and other profit making schemes -- they've admitted as much.

  • RalfW on June 12, 2012 6:17 PM:

    How nice of United Healthcare. But if they change their minds and ACA is gone, well, they just can. At their whim. Sure, they'd have angry customers, but if it's to their bottom line to drop 22-26 year olds some day, they'll be free to do it.

    Insurance was devised to provide certainty. Market forces as they are practiced in the for-profit insurance industry have caused most of the certainty to be gone from health insurance. ACA tried to regain some predictability to issuance, coverage, and access.

    But I think the Supremes will put an end to that core purpose of insurance. Let's hope the ensuing chaos leads to single payer!

  • paul on June 14, 2012 10:33 AM:

    Just sayin', but didn't most people in their 20s use to get health insurance (and thus health care) as a function of having jobs at an employers who provided same? The individual market has almost always been too expensive.

    On the other hand, a conservative would no doubt look at the fact that 60% of young adults can finance their health care out of pocket (and very few of the rest died because of lack of access) and say everything is working fine.

  • Chris on June 21, 2012 10:20 AM:

    Without any doubt a health insurance policy is must for everybody bit before choosing one you must see for both benefits and drawbacks, thanks nisha