Nchc Fact Sheet - Young Adults

Health Care Facts: Young Adults

Young adults – individuals between the ages of 19 and 29 – represent less than 20% of the nation’s population 1 , but make up nearly 30% of the nation’s uninsured, with an uninsured rate (31%) almost double that of the rate for the entire non-elderly population (17.9%). 2 (Figure 1)

Figure 1: Insurance Coverage of Non-Elderly Population, 2006

Young adults typically start off with coverage under their parents’ plan/s or are covered under a public plan. 3 However, the average health plan discontinues coverage at the age of 19. 4 Thereafter, young adults are faced with the daunting prospect of purchasing individual coverage or if employed, seeking insurance through their employer. The choices are limited. SOURCE: KCMU/Urban Institute analysis of March 2007 CPS.

This population faces a myriad of unique health care challenges which are only worsened by the lack of affordable and adequate health coverage. More than half of this population are full-time workers, though many of the jobs available – entry level and temporary positions – may not offer health insurance. 5 As a result of limited access and affordability – as well as the belief in their own “invincibility” when it comes to future health concerns (see page 2) – many young citizens forgo treatment, avoid preventive services, refrain from seeking medical attention for an identified medical problem and choose not to invest in health coverage. 6 MYTH OF THE NOT-SO “INVINCIBLES” ¾ Contrary to popular belief, young adults are, in fact, more susceptible to specific types of injury and illness than any other population. ¾ The incidence of sexually transmitted diseases (STDs) is highest among young adults, specifically Chlamydia, Gonorrhea, Human Papillomavirus (HPV), and HIV. 7 ¾ Chronic diagnosable mental health and substance abuse disorders usually begin by the age of 24. 8 ¾ Young adults infrequently seek or receive preventive care, relative to other groups. 9 ¾ Young adults have nearly three times the rate of suicide of adolescents. 10

WHAT IS THE AVERAGE COST OF HEALTH COVERAGE FOR YOUNG ADULTS? ¾ For the school year 2007-2008, the average health insurance premium was $850. 11 ¾ A very attractive option among young adults is the high-deductible health plan, with deductibles starting from $1,000. 12 ¾ Deductible costs, the out-of-pocket medical expenses that must be paid before the health insurance company begins covering a percentage of medical expenses, typically range from $1,150 to as high as $5,800. 13 ¾ The employee share for employer-sponsored single coverage health insurance rose from $324 in 1999 to $779 in 2009. 14 National Coalition on Health Care

October 2009

CAN YOU AFFORD NOT TO HAVE INSURANCE? ¾ Financial burdens incurred by uninsured young adults seeking emergency medical services often follow that individual for an extensive period of time. ¾ One out of ten uninsured young adults paid more than $700 in out of pocket expenses for medical care in 2005. 15 ¾ A 2008 report revealed that 25% of uninsured young adults reported that they were contacted by a collection agency regarding past due medical expenses. ¾ Even common illnesses and conditions can create significant financial burdens. (Table 1) ¾ An inability to pay medical expenses can have a detrimental effect on one’s family, credit rating, student loan debt, future planning.

Table 1: Average Cost for Common Health Conditions Flu and Strep Diagnosis in Doctor’s Office

$90-$190

Emergency Room Visit for Flu or Strep

$329

Urgent Care for Broken Ankle

$429

Diabetes, Annual Treatment

$13,243

Depression, Diagnosis and Treatment

$13,929

Breast Cancer for Women, 20-30

$19,508*

Motorcycle Accident, with helmet

$31,158

Motorcycle Accident, without helmet

$37,317

Leukemia or Brain Cancer, Diagnosis and Treatment

$723,814

* Per Incident, Cost for Chemotherapy and Radiation not included.

Sources: Blue Cross, 2007, Minnesota Council of Health Plans (MCHP), 2002; MCHP, 2002; mean cost of employees who went on disability due to depression, based on a study by the American Psychiatric Association, 2001; Blue Cross, 2005; University of Michigan study, 2002; Centers for Disease Control, 2003; Antioch University, Seattle, Washington, 2005

CAN AMERICA AFFORD FOR YOU NOT TO HAVE INSURANCE? ¾ In 2007, 27% of young adults who characterized their health as excellent were uninsured, compared to the 40% uninsured in this group who characterized their health as fair or poor. 16 ¾ Many uninsured young adults who are not healthy, or who fall ill, use expensive emergency room care as a substitute to seeing a primary physician. This cost of such uncompensated care – estimated to be $40.7 billion in 2004 17 – is passed on to the insured, further increasing health care costs on individuals and employers, which can lead to more uninsured people. 18 ¾ Because of risk-pooling – a mechanism for stabilizing the cost of health care by balancing low and high risk populations – healthy young adults who choose not to purchase health coverage create a disproportionate number of high risk individuals in health plans, thereby increasing the cost of insurance for all. 19

WHAT ARE THE MAJOR AREAS THAT DEMAND REFORM? ¾ Cost: America is on an unsustainable path with regard to health care costs. National health care spending will reach $2.5 trillion by the end of 2009 and is projected to reach $4.4 trillion by 2018. 20 Businesses, large and small, are unable to keep up with rising insurance premiums, which leads them to cut benefits, raise deductibles and co-pays, or simply terminate employees. Without immediate cost containment and implementing measures to bend the cost curve, more Americans will lose their health coverage. ¾ Quality: Out of 19 industrialized countries surveyed, the U.S. ranked dead last in the number of preventable deaths resulting from poor quality health care. 21 Approximately 101,000 deaths could have been prevented if the United States had just the same mortality rate as other leading countries. 22 ¾ Coverage: Studies estimate that 22,000 people between the ages 25-64 die per year due to lack of adequate health coverage. 23 This is likely due to the fact that the uninsured are 9 to 10 times more likely to forgo medical treatment or seek preventive services. 24 National Coalition on Health Care

October 2009

References 1

Holahan, John and Kenney, Genevieve. “Health Insurance Coverage of Young Adults: Issues and Broader Considerations”. Washington, DC. Urban Institute. June 2008. Available at: http://www.urban.org/UploadedPDF/411691_young_adult_insurance.pdf 2 Schwartz, Karyn and Schwartz, Tanya. “Uninsured Young Adults: A Profile and Overview of Coverage Options” Washington, DC: Kaiser Family Foundation. June 2008. Available at: http://www.kff.org/uninsured/upload/7785.pdf 3 Ibid 4 Ibid 5 “What You Need to Know: Young People and Health Insurance”. National Women’s Law Center. Available at http://nwlc.org/reformmatters/pdf/RWV-YoungWomenFactSheet.pdf 6 Holahan, John and Kenney, Genevieve. “Health Insurance Coverage of Young Adults: Issues and Broader Considerations”. Washington, DC. Urban Institute. June 2008. Available at: http://www.urban.org/UploadedPDF/411691_young_adult_insurance.pdf 7 What You Need to Know: Young People and Health Insurance”. National Women’s Law Center. Available at http://nwlc.org/reformmatters/pdf/RWV-YoungWomenFactSheet.pdf 8 Ibid 9 Robert J. Fortuna, MD, MPH; Brett W. Robbins, MD; and Jill S. Halterman, MD, MPH. “Ambulatory Care Among Young Adults in the United States.” 151 (6): 379 Annals of Internal Medicine. Available at http://www.annals.org/cgi/content/abstract/151/6/379 10 What You Need to Know: Young People and Health Insurance”. National Women’s Law Center. Available at http://nwlc.org/reformmatters/pdf/RWV-YoungWomenFactSheet.pdf 11 Megan Johnson. “Affordable Health Insurance for Young Adults.” US News and World Report. Available at http://health.usnews.com/articles/health/health-plans/2009/04/22/affordable-health-insurance-for-young-adults.html 12 Karen Davis, Michelle M. Doty, and Alice Ho. “How High Is Too High? Implications of High-Deductible Health Plans.” The Commonwealth Fund. Available at http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2005/Apr/How%20High%20Is%20Too%20High%20%2 0Implications%20of%20High%20Deductible%20Health%20Plans/816_Davis_how_high_is_too_high_impl_HDHPs%20pdf.pdf 13 IRS Publication 969. Health Savings Accounts and Other Tax-Favored Health Plans. Available at http://www.irs.gov/pub/irspdf/p969.pdf 14 Kaiser Family Foundation. “Employer Health Benefits, 2009 Annual Survey”, 2009 15 KCMU Analysis of 2005 MEPS Data 16 Schwartz, Karyn and Schwartz, Tanya. “Uninsured Young Adults: A Profile and Overview of Coverage Options” Washington, DC: Kaiser Family Foundation. June 2008. Available at: http://www.kff.org/uninsured/upload/7785.pdf 17 Hadley, Jack and Holahan, John. “The Cost of Care for the Uninsured: What Do We Spend, Who Pays, and What Would Full Coverage Add to Medical Spending?” Washginton, D.C: Kaiser Family Foundation. May, 2004. Available at: http://www.kff.org/uninsured/upload/The-Cost-of-Care-for-the-Uninsured-What-Do-We-Spend-Who-Pays-and-What-Would-FullCoverage-Add-to-Medical-Spending.pdf 18 “Condition Critical: Ten Prescriptions for Reforming Health Care Quality, Cost, and Coverage”. American Benefits Council. January, 2009. Available at: http://www.americanbenefitscouncil.com/documents/condition_critical2009.pdf 19 “Glossary of Key Health Reform Terms”, Washington, DC. Kaiser Family Foundation. Available at: http://www.kff.org/healthreform/upload/7909.pdf 20 Siska, A, et al, Health Spending Projections Through 2018: Recession Effects Add Uncertainty to The Outlook Health Affairs, March/April 2009; 28(2): w346-w357. 21 The Commonwealth Fund Commission on a High Performance Health System. “Why Not the Best? Results from the National Scorecard on U.S. Health System Performance, 2008.” The Commonwealth Fund. July 2008. Available at: http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2008/Jul/Why%20Not%20the%20Best%20%20Results %20from%20the%20National%20Scorecard%20on%20U%20S%20%20Health%20System%20Performance%20%202008/Why_Not_the _Best_national_scorecard_2008%20pdf.pdf 22 Ibid 23 Dorn, S, “Uninsured and Dying Because of It: Updating the Institute of Medicine Analysis on the Impact of Uninsurance on Mortality,” Urban Institute, 2008. 24 National Center for Health Statistics. “Health, United States, 2007: with Chartbook on Trends in the Health of Americans,” 2007; Center for American Progress, The Case for Health Reform, February 2009.

National Coalition on Health Care

October 2009