Health Care Reform (Mostly) Promising for Twenty-Somethings

This is part three of my series on the current state of health care reform. Health issues change as we traverse the lifespan, and different age groups have unique health care needs. In this third post in the series of three looking at how the Affordable Healthcare Act affects you, Didi Thompson, who is in her 20’s, takes a look at what’s in the bill for her agemates. Didi is a senior analyst at a health care research and consulting firm in Washington, D.C., and will pursue a Master of Science in International Health Policy at the London School of Economics this fall. Check out her commentary–compare to parts one and two of this series– and let us all know what you think.

Young adults ages 19 to 29 make up less than 15 percent of the total US population, yet they comprise a staggering 30 percent of the 46 million uninsured and have the highest rate of uninsurance among any age group. Therefore, it’s no surprise that the vast majority of this group—88 percent, according to a survey conducted by the Commonwealth Fund —support health care reform.

Obtaining health insurance in the current market is particularly difficult for young adults, as many health insurers drop dependents from their parents’ plans once they turn 19 or graduate from high school or college. Add to this the fact that many twenty-somethings are beginning their careers in low-paying, entry-level jobs which do not provide health care benefits, and it’s easy to see why nearly one in three young adults is uninsured. However, with the passage of the health reform bill, this statistic is set to change. Though most reform provisions won’t take effect until 2014, beginning this September, young adults up to age 26 will be eligible to obtain coverage through their parents’ insurance plans. This law has the potential to benefit over 8.8 million currently uninsured adults between the ages of 19 and 25. Further, over 65 companies have already extended coverage to this group since the health reform bill passed.

Although other pieces of the legislation do not directly focus on young adults, this population stands to benefit in numerous ways. The bill’s tax credits to small businesses will encourage these firms to offer health coverage to employees, including the 36 percent of employed uninsured young adults who work for companies with fewer than 25 employees—according to an estimate by the Kaiser Family Foundation. Additionally, the expansion of Medicaid eligibility to 133 percent of the federal poverty line will extend coverage to over 50 percent of uninsured young adults. Finally, health reform will not only increase the number of people with health insurance, it will also improve coverage benefits, particularly for women. Preventive services, including pap smears and STI screenings, will be covered at full cost—making services more accessible to low-income women for whom co-pays can be prohibitive—and all basic insurance policies will be required to include maternity care.

While the reform act will without a doubt improve health care for young men and women, it’s important to note what it won’t provide: comprehensive reproductive health coverage for all. As a young woman, I’m thrilled that health reform will allow more of my peers access to important reproductive health services, including STI screening and contraceptive coverage. However, I find it troubling that the new law continues to prohibit the use of federal funds for abortion services, particularly as this restriction hurts those most in need of family planning services: low income women. The fact that women in this country still lack access to comprehensive reproductive health services and education—which contributes to the US ranking a dismal 39th in maternal mortality while maintaining the highest teen birth rate of any industrialized nation—is a startling reminder that health reform is far from complete.

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