SCOTT SIMON, HOST:
In the State of Texas, implementing the Affordable Care Act has turned out to be a challenge. Many young and low-income people can be skeptical about signing up for healthcare coverage as Carrie Feibel of Houston Public Media reports.
CARRIE FEIBEL, BYLINE: It's lunchtime on the North Harris campus of Lone Star Community College. Students stream through the lobby of the student services center, plugged into their headphones or rushing to class. Many walk right past a small information table about the Affordable Care Act. The table is the brainchild of Megan Franks, a health and fitness professor. Franks says getting overworked students to stop and learn about the law is tough.
MEGAN FRANKS: If you say Obamacare, they know what you're saying. If you say Affordable Care Act, they walk by without any ding-ding-ding. So then we throw out the word penalty - zoom - they've never heard that before. Penalty? That really tends to be a hook more than, gee, you really need health care.
FEIBEL: Franks says many students at Lone Star are low income. They often work, some have families to support. Other's struggle to find gas money to even get to class.
FRANKS: I still think so many of them are at survival mode. It's not even I'm invincible. It's like health insurance, really, you know? I've got to get to work.
FEIBEL: She could be talking about Adan Castillo. He's 19 and wants to be a detective or maybe join the Marines. In addition to his classes, he also works. Castillo actually used to be insured. He paid his parents $55 a month to keep him on their health plan, but he says it just felt like throwing money away.
ADAN CASTILLO: So I just started, like, I just stopped giving it to them because there's other important things, like, I have to do. I pay for my college books, classes, gas. Gas is expensive nowadays. Like, come on, you know. So I can use it for those type of things now.
FEIBEL: But Adan's girlfriend, Leslie Gonzalez, says insurance is important. She's an accounting student.
LESLIE GONZALEZ: Well, he needs it 'cause let's say he doesn't have it right now and he gets in an accident. He's going to have to pay everything out of pocket and what if he doesn't have it?
FEIBEL: Gonzalez works part time as a bank teller. She says she will sign up for insurance at work as soon as she is eligible. The stereotype about young people is that they think they're invincible, that they don't need insurance because nothing bad will happen to them for years. But most young adults don't actually think that way. Two recent surveys reveal that cost is the real issue. Young people think health coverage is expensive and they assume they can't afford it.
And they simple don't know that the law may offer them subsidies to help pay for insurance. Taylor Castille is a nursing student in her second year at Lone Star. She has logged on to Healthcare.gov but her first visit didn't go very well.
TAYLOR CASTILLE: I finally got on the website the other day and it was, like, kind of confusing to me because I didn't understand, like, if I'll have to pay, what I pay, what I'm not paying. It was just really confusing and I got stressed out all over again just looking at that, so I just left the site and...
FEIBEL: Castille still wants coverage. Last fall, she suffered a series of fainting spells and seizures. After a few visits to the ER, she now has $30,000 in debt.
CASTILLE: I'm 21. I haven't bought a car, I haven't done anything. I don't have the debt because of being irresponsible. I have the debt because I was sick.
FEIBEL: Castille latter visited the information table and got a flyer on how to sign up for a health plan. So far, only about 25 percent of people who have signed up are young adults. The federal government is hoping to nudge that proportion closer to 40 percent. The deadline to enroll for all ages is March 31st. For NPR News, I'm Carrie Feibel in Houston.
SIMON: This story is part of a reporting partnership with NPR, Houston Public Media and Kaiser Health News.
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