Young Adults and Health Insurance

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 today that they 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 ACA. 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.

About Don Taylor
Professor of Public Policy (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute), and Chair of the Academic Council at Duke University . I am one of the founding faculty of the Margolis Center for Health Policy. My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

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