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Health Care Facts: Young Adults

Young adults – individuals between the ages of 19 Figure 1: Insurance Coverage of Young Adult
and 29 – represent less than 20% of the nation’s Population, 2008
population1, but make up nearly 30% of the nation’s
uninsured. In 2008, according to the National Health
Interview Survey, almost 13 million young adults, or
one third of this population, did not have health
insurance.2 (Figure 1)

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 SOURCE: Cohen RA, Bloom B. Access to and utilization of medical care for
young adults aged 20-29 years: United States, 2008. NCHS data brief, no
individual coverage or if employed, seeking insurance 29. Hyattsville, MD: National Center for Health Statistics. 2010.
through their employer. The choices are limited.

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”


 Contrary to popular belief, young adults are, in fact, more susceptible to specific types of injury and illness
than any other population.
 The incidence of sexually transmitted diseases (STDs) is highest among young adults, specifically
Chlamydia, Gonorrhea, Human Papillomavirus (HPV), and HIV.7
 Chronic diagnosable mental health and substance abuse disorders usually begin by the age of 24.8
 Young adults infrequently seek or receive preventive care, relative to other groups.9
 Young adults have nearly three times the rate of suicide of adolescents.10

WHAT IS THE AVERAGE COST OF HEALTH COVERAGE FOR YOUNG ADULTS?


 For the school year 2007-2008, the average health insurance premium was $850.11
 A very attractive option among young adults is the high-deductible health plan, with deductibles starting
from $1,000.12
 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
 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
Table 1: Average Cost for Common Health Conditions
INSURANCE?
 Financial burdens incurred by uninsured young Flu and Strep Diagnosis in Doctor’s Office $90-$190
adults seeking emergency medical services Emergency Room Visit for Flu or Strep $329
often follow that individual for an extensive
Urgent Care for Broken Ankle $429
period of time.
Diabetes, Annual Treatment $13,243
 One out of ten uninsured young adults paid Depression, Diagnosis and Treatment $13,929
more than $700 in out of pocket expenses for
Breast Cancer for Women, 20-30 $19,508*
medical care in 2005.15
Motorcycle Accident, with helmet $31,158
 A 2008 report revealed that 25% of uninsured Motorcycle Accident, without helmet $37,317
young adults reported that they were contacted
Leukemia or Brain Cancer, Diagnosis and Treatment $723,814
by a collection agency regarding past due
medical expenses.
* Per Incident, Cost for Chemotherapy and Radiation not included.
 Even common illnesses and conditions can
create significant financial burdens. (Table 1)
Sources: Blue Cross, 2007, Minnesota Council of Health Plans (MCHP), 2002;
 An inability to pay medical expenses can have MCHP, 2002; mean cost of employees who went on disability due to
depression, based on a study by the American Psychiatric Association, 2001;
a detrimental effect on one’s family, credit Blue Cross, 2005; University of Michigan study, 2002; Centers for Disease
rating, student loan debt, future planning. Control, 2003; Antioch University, Seattle, Washington, 2005

CAN AMERICA AFFORD FOR YOU NOT TO HAVE INSURANCE?


 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
 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 200417 – is passed on to the insured, further increasing health care costs on individuals and employers,
which can lead to more uninsured people.18
 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?


 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.

 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

 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
Cohen RA, Bloom B. Access to and utilization of medical care for young adults aged 20-29 years: United States, 2008. NCHS data
brief, no 29. Hyattsville, MD: National Center for Health Statistics. 2010.
3
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
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/irs-
pdf/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-Full-
Coverage-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