TOPICS > Health

For Young Americans, Health Insurance is Often Elusive

September 17, 2009 at 12:00 AM EDT
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President Obama took his health reform call to young people Thursday with a speech at the University of Maryland. Kwame Holman reports on the challenges faced by the more than 10 million Americans between the ages of 19 and 26 without health insurance.

JUDY WOODRUFF: And still to come on the NewsHour tonight: Minority Leader Boehner; malaria in Tanzania; Senator Kennedy’s memoir; and folk singer Mary Travers.

That follows our close-up on young Americans without health insurance. NewsHour correspondent Kwame Holman has the story for our Health Unit. The unit is a partnership with the Robert Wood Johnson Foundation.

KWAME HOLMAN: Hannah Howard lives every day with chronic pain.

HANNAH HOWARD: I have several gynecological problems, and I hurt my back a few weeks ago. I’m in constant pain.

KWAME HOLMAN: The tiny home-based marketing company in Rockville, Md., where the 21-year-old works can’t afford to provide coverage, and Howard says an individual plan is far too expensive.

HANNAH HOWARD: Anything with a deductible under a thousand dollars and a co-pay to go see physicians is way out of my price range. And anything in my price range has a deductible of about $5,000, which doesn’t help me at all.

KWAME HOLMAN: Howard is not alone. Nearly 14 million young people — about a third of those aged 19 to 29 — are uninsured. They’re the largest segment of the country’s 46 million uninsured and one of the primary targets for coverage under the insurance overhaul bills moving through Congress.

DIANE ROWLAND, executive vice president, Kaiser Family Foundation: It’s quite reasonable that many of them can’t afford health insurance coverage.

KWAME HOLMAN: Diane Roland of the Kaiser Family Foundation is an expert on the uninsured.

DIANE ROWLAND: They’re losing coverage through their parents’ policy as they age. They’re no longer eligible for the coverage under Medicaid that’s offered to people under age 19.

Many can't afford coverage

KWAME HOLMAN: Young adults have been dubbed "young invincibles," because most are healthy and think they'll stay that way. But it's also true that many young people simply can't afford to buy coverage. About half of them earn less than $16,000 a year; only 10 percent have completed college. And even those who have often find themselves in low-wage or part-time jobs that don't offer benefits.

Twenty-two-year-old Yewande Akinleye has been waitressing in Washington, D.C., since she graduated from college.

YEWANDE AKINLEYE: Every time I try to apply for a job, I'm always looking for the benefits packet or health care. So that is my main goal, more than even getting paid, a little bit.

KWAME HOLMAN: One insurance option for young adults is a so-called bare-bones policy offered by some companies. Premiums are relatively low, but coverage kicks in only for high-cost catastrophic illnesses.

DIANE ROWLAND: You might have a deductible of $3,000 or $4,000 or even $5,000 that you have to pay out of pocket for health care expenses before you get any health insurance coverage. So that may help you if you have a cancer diagnosis or a really catastrophic auto accident, but it won't help you very much to get some of the basic primary and preventive care that you need.

In addition, many of the bare-bones plans may prevent the individuals from being able to even afford their deductible and drive them into medical debt.

KWAME HOLMAN: Young adults who spent any time uninsured were twice as likely to have medical debt as their peers who were insured throughout the year, according to a report by the Commonwealth Fund last month. It found nearly half of uninsured young adults reported difficulties paying medical bills, and 37 percent were carrying medical debt.

Some young people sign up for temporary insurance plans that end after a period of time and are not guaranteed renewable.

President Obama took his push for health insurance reform before a group of young people at the University of Maryland today.

U.S. PRESIDENT BARACK OBAMA: Thank you, College Park!

Obama pushes health care reform

KWAME HOLMAN: His plan would mandate that young adults and everyone else get insurance or pay a penalty, but offer government subsidies for those who can least afford it.

BARACK OBAMA: Health care's about more than the details of a policy; it's about what kind of country you want to be.

KWAME HOLMAN: Many heard the call, including 24-year-old student Emma Sandue.

EMMA SANDOE: I'm here because I support health care reform, and I want everyone to have the chance to have health insurance and the security and safety of knowing that it's there for them if they need it.

KWAME HOLMAN: But many young people are confused.

HANNAH HOWARD: I'm following it pretty closely, and I don't understand any of it.

KWAME HOLMAN: Two young Georgetown Law School students have set out to change that. They launched an organization called "Young Invincibles." Their Web site carries stories from the young and uninsured and calls on them to be more involved in the health care reform debate.

Ari Matusiak is a co-founder.

ARI MATUSIAK: The health care crisis is our crisis. Giving them the facts about why that's the case, telling the stories of young Americans and their experiences in the health care system, and mobilizing our community so that our voices are heard as the decisions are being made in Washington.

Resisting health insurance

KWAME HOLMAN: Matusiak and co-founder Aaron Smith volunteered on the Obama presidential campaign. They want to make sure reform meets the needs of the young.

AARON SMITH: We also believe that every American should have health insurance.

KWAME HOLMAN: And some young people resist the idea of being required to purchase health insurance. Clark Ruper is a 23-year-old marketing consultant.

CLARK RUPER: I make enough that I would be forced under these plans to buy insurance on my own. So I'm left in the middle. So I'm left paying for something that I don't want because some bureaucrat decided that I should.

KWAME HOLMAN: Like many his age, Ruper has gone in and out of health coverage by choice.

CLARK RUPER: I understand my situation, and I accept the consequences. I change jobs a lot; I change employers often. Right now, I choose to be uninsured. I have the money in the budget for it, but right now I choose to invest in other things like my savings, my gym membership, those sorts of things, that I try invest in my health, instead of paying for, you know, being sick after the fact.

KWAME HOLMAN: Young adults such as Ruper may be able to put off getting health insurance, but those like Hannah Howard worry about how they'll fare without it.s