Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help
By Sara R. Collins, Cathy Schoen, Jennifer L. Kriss, Michelle M. Doty, and Bisundev Mahato
The Commonwealth Fund
May 2006
Young adults (ages 19 to 29) are one of the largest and fastest-growing segments of the U.S. population without health insurance: 13.7 million lacked coverage in 2004, an increase of 2.5 million since 2000.Young adults often lose coverage under their parents’ policies, Medicaid, or the State Children’s Health Insurance Program at age 19, or when they graduate from high school or college. Nearly two of five college graduates and one-half of high school graduates who do not go on to college will be uninsured for a period during the first year after graduation. Three policy changes could extend coverage to uninsured young adults and prevent others from losing it:
extending eligibility for Medicaid and the State Children’s Health Insurance Program beyond age 18; extending eligibility for dependents under private coverage beyond age 18 or 19 regardless of student status; and ensuring that colleges and universities require full- and part-time students to have insurance, and that they offer coverage to both.
http://www.cmwf.org/usr_doc/Collins_riteofpassage2006_649_ib.pdf
Comment:
By Don McCanne, M.D.
It has long been recognized that young adults are the largest and fastest growing group of the uninsured. As a result, policymakers in public and private sectors have been adopting changes designed to expand coverage of young adults. Some of those efforts have been identified in this report, and they include the specific policy recommendations listed.
Although we recognize that these policies would increase coverage, converting them into action on a widespread basis has been and will remain elusive. If you doubt that, look at the recommendations again and decide what rules and regulations you would need, how they would be enforced, and how they would be funded. Confirming the difficulties encountered, efforts to date to adopt these incremental changes have resulted in an INCREASE of 2.5 million in the numbers of uninsured young adults.
Incremental efforts have already been tested, and they have failed. Only fundamental structural reform will accomplish our goal of equitably-funded, comprehensive coverage for everyone. Policymakers need to abandon the path of incrementalism that is leading us to more uninsured, greater medical debt, and more barriers to care. A single payer program of national health insurance is the obvious solution. Can’t the policymakers find that path?