Health care debate looks at uninsured young adults

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They met in college and knew instantly they were meant to be together.

She planned to be a lawyer; he would get his MBA and work for a large firm. Nothing seemed beyond their reach when Robert Andrzejewski proposed to Jamie Young.

But before they could say "I do," the young couple found themselves mired in a world where surviving with limited health insurance was more important than any plans for the future. Andrzejewski's mysterious back pain was so bad, he needed a cane to hobble to the altar.

As challenging as their lives became — Andrzejewski suddenly found himself bedridden with $16,000 in out-of-pocket expenses one year — the couple were among the lucky ones even to have health insurance.

Young adults ages 19 to 29 are less well-protected by health insurance than any other age group in the United States: Almost one in three have no insurance and many more are underinsured. And as the country grapples over how to provide coverage to Americans, figuring out how to cover young adults, from all income levels, has become a tricky and significant subtext in the reform debate.

"We had to be on such a strict budget just to get by," said Jamie Andrzejewski, 28, now a second-year law student at Santa Clara University. "I would walk into the grocery store and spend to the penny what we could afford. I would fill the grocery cart and write down the cost. There were times I had panic attacks."

CRITICAL CHOICES

For the underinsured such as the Andrzejewskis and many of the more than 10 million uninsured young adults, critical choices must be made constantly: tuition and books or health insurance, rent or a trip to the doctor's office.

"I'd always known that health insurance was very important but I couldn't afford it," said Mary Ann Nguyen, 27, a second-year law student at SCU. "Even now, I'm using my student loan to pay for health insurance."

Surprisingly, graduating from college and landing a job doesn't automatically mean having health coverage. More than half of the uninsured young adults are full-time workers, according to a 2008 study by the Kaiser Family Foundation. That's because those first jobs often don't come with affordable health plans.

"It's a time in their life when they're just starting out," said Sara R. Collins, vice president for the Affordable Health Insurance Program at the Commonwealth Fund, a private foundation that promotes an improved health care system. "You don't want them going without health insurance. Obesity rates have gone up so much in this age group."

While 31 percent of adults ages 19-29 have no insurance, only 17 percent of adults ages 30-64 are uninsured. Young adults make up about 18 percent of the adult population but make up 28 percent of the overall uninsured adult population, according to the Urban Institute.

The gap is so critical and so costly that House Speaker Nancy Pelosi last week announced a new provision proposed for the health insurance reform bill: It would allow young people to remain covered under their parents' insurance plan until their 27th birthday.

LONGER PARENTAL COVERAGE

In California, parents can cover their children until age 19, and in some cases until age 23 if they are full-time college students. At least 20 other states have increased the age of covering dependents into the mid-20s; New Jersey allows coverage up to age 30.

Such an option would've protected 26-year-old Joseph Flannery.

He had just gone off his mother's insurance plan when he had a skiing accident at Lake Tahoe. He had trouble breathing but thought if he could just get home, he'd be OK and Mom could take care of him.