'Young Invincibles' Have Stake In Health Debate

They're known as the "young invincibles" — healthy people, ages 19-26, who don't have health insurance. And they've got a big stake in the Capitol Hill debate over health care — even if many get lost in the details of the discussion. Host Guy Raz introduces several of the young uninsured and talks with Genevieve Kenney, a health economist at The Urban Institute in Washington, D.C.

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GUY RAZ, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Guy Raz.

This hour, stories from the frontlines of the health care debate to a shake up at a tradition-bound Southern college. But first, to the so-called young invincibles.

When the Senate returns to debate health care this week, one group that might get lost in the discussion, the millions of young people without insurance. About a quarter of uninsured Americans are roughly between the ages of 19 and 26. That means about one in every three young adults go without coverage.

In a few minutes, we'll hear from Senator Tom Harkin of Iowa, the new chairman of the Senate Health Committee, about how he plans to tackle the problem.

For the moment, though, we begin with a group of young people we met this past week at the Latin American Youth Center here in Washington, D.C.

Mr. SHANDON JOHNSON(ph): Hey, my name's Shandon Johnson. I'm 24, and no, I don't have health insurance.

RAZ: Shandon Johnson works at a local hotel and is taking classes to earn his high school equivalency degree, the GED. He says he used to be insured.

Mr. JOHNSON: Just regular, I guess, public assistance health insurance, got older and got taken off and just never re-applied for the insurance.

RAZ: According to researchers, it's a common problem.

Ms. GENEVIEVE KENNEY (Health Economist, The Urban Institute): When someone turns 19, they are much less likely to qualify for publicly subsidized coverage, or they're no longer full-time students and can't qualify under their parents' plans in many places. So kids lose both private and public coverage when they turn 19.

RAZ: That's Genevieve Kenney. She's an economist at The Urban Institute here in Washington, D.C., and she specializes in health care for children and young adults.

After age 19, she says, few young adults find jobs with health benefits, and if they want coverage, the cost can be prohibitive. For those who can afford it, many choose to opt out. They're known as the young invincibles.

Ms. KENNEY: There are some higher-income young adults who are in good health who don't see the value in purchasing health insurance coverage. But I think many of the young adults who are uninsured don't have the financial wherewithal to really pay much for coverage.

RAZ: According to The Urban Institute, almost half of uninsured young adults make less than $14,000 a year.

Ms. ADELA YOUSETA(ph): It's not that we don't want to have health insurance. I think we all want health insurance, it's just that we don't have the money or, you know, all the information that we need to get health insurance.

RAZ: That's 18-year-old Adela Youseta. She has health insurance now from her job as a receptionist in suburban Maryland, but she remembers what it felt like when her family didn't have it.

Ms. YOUSETA: We were worried about, you know, about that at that time. Like, what should we do if we get sick, you know, do we just go to CVS and get, you know, Advils? Like, is it really going to work?

RAZ: Shandon Johnson knows that feeling.

Mr. JOHNSON: Worries in the back of your head like how much is this going to cost? Do I have to work overtime just to pay it off, or do I got to get another job to pay the bills off?

RAZ: Tempest Johnson(ph) is also working toward her GED. She's 17 and says her family can't afford to buy insurance.

Ms. JOHNSON: For a family of five, that's $700 a month, and that's my mother's rent money. So it's either health insurance or rent.

RAZ: According to The Urban Institute, uninsured young people are more than twice as likely not to see a doctor when they have a medical problem. Tempest Johnson says if her family were insured, she thinks they would all be healthier.

Ms. JOHNSON: We would go to the doctor more. We would know what we have and what we don't have, what might be developing in us that we have no idea what is developing.

RAZ: And for Tempest Johnson and the other young folks we met, the current debate in Congress is too confusing to follow.

Ms. JOHNSON: I get the newspaper and look at TV, but it's all these other big stories that come to my attention; and health care, I never really cared about.

RAZ: The task of working this population of uninsured adults into health care reform is now up to members of Congress, debating just a few miles away from where we met Shandon, Adela and Tempest. The bills being considered now would expand coverage to young people by increasing subsidies to buy insurance. But The Urban Institute's Genevieve Kenney still has questions about how those bills would work.

Ms. KENNEY: How generous will the subsidies be? Will they actually make coverage affordable for young adults in that middle-income range? And the proposals include a mandate for coverage.

RAZ: Since young adults are more likely to be healthy, a mandate to buy insurance could place an extra burden on this group, a burden to subsidize health care for the older and sicker population. But supporters of health care overhaul say requiring young people to buy insurance is essential to paying for the overall package. They don't cost the system as much, and so young people, by paying for it, would dilute the overall price tag of health care for everyone else.

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