A report released by the nonpartisan Employee Benefit Research Institute notes what could be really good news: The health-care reform signed into law by President Obama, which has been criticized by Republicans and challenged in court, appears to be improving the health insurance coverage of young adults.
The Patient Protection and Affordable Care Act requires that group health plans and insurers make dependent coverage available for young adults until their 26th birthday, regardless of their student status or whether they are being financially supported by their parents. Insurers also can’t limit dependent coverage based on whether the young adult is married, although the law does not extend coverage to the spouse or children of the young adult.
EBRI pulled together its results by examining data from two Census Bureau surveys and from the National Health Interview Survey by the Centers for Disease Control and Prevention. In looking at the census data, which were greeted with skepticism because they covered such a short period after the health-care reform kicked in, EBRI notes that the percentage of people between ages 19 and 25 being carried as a dependent on a parent’s employment-based coverage increased from 24.7 percent in 2009 to 27.7 percent in 2010. The number of young adults with employment-based coverage as a dependent increased from 7.3 million to 8.2 million.
“It should be noted, however, that the increase in employment-based coverage as a dependent could be the result of individuals losing coverage through work and thus moving from employment-based coverage in their own name to employment-based coverage as a dependent,” wrote Paul Fronstin, author of the report and director of EBRI’s Health Research and Education Program.
It may also be true that there wasn’t so much a gain as a shift in where young adults were getting their health-care coverage. But this still means that the part of health-care reform intended to make sure people have coverage is working. I’ve talked to a number of young adults who couldn’t afford health insurance on their own who are grateful they didn’t join the ranks of the uninsured.
When you combine the census data with the report from the CDC, which covers a longer period in following the new rule for young adults, the number of those 19 to 25 with private insurance increased from 51 to 55.8 percent, and the percentage of uninsured fell from 33.9 percent in 2010 to 28.8 percent during the first half of 2011.
“When you look at the uninsured numbers, you do find an impact,” Fronstin said in an interview.
These reports matter as we continue to examine the effectiveness of health-care reform. The Labor Department reports that young adults have the highest rate of being uninsured of any age group. Despite the gains under the new law, things are still not great for young people when it comes to health insurance. About 30 percent of young adults, compared with 17 percent of older adults, are uninsured, representing more than one in five of the uninsured. This rate is three times higher than the uninsured rate among children.
Young adults have the lowest rate of access to employer-based insurance because they often have entry-level or part-time jobs, or they work in small businesses or other areas that typically come without employer-sponsored health insurance, according to the Labor Department.
And there is this to consider: Just because you’re young doesn’t mean you don’t need health insurance. One in six young adults has a chronic illness such as cancer, diabetes or asthma. Nearly half of uninsured young adults report problems paying medical bills.
This brings me to the downside in another EBRI paper that looked at the health-care spending of older Americans using survey information from the National Institute on Aging and the Social Security Administration. People were asked if, to save money, they had made changes in prescription drugs, skipped or postponed doctor appointments, or found it difficult to pay their monthly bills.
Older adults, especially the most medically vulnerable, said they did make such changes. Among those who said they were in poor health, 29.9 percent made prescription drug changes and 36.5 percent skipped or postponed doctor appointments to save money, according to the EBRI paper.
Taken together, the data show we are just making a dent in finding a way to ensure that people have access to affordable health care, Fronstin said. The number of people without health insurance coverage is close to 50 million.
“We still have a long way to go,” Fronstin said.
Yes, we do.
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