By Amanda Cuda
Can a pair a of tighty whities — and the well-meaning nagging of the nation’s moms — get young adults to sign up for health insurance?
The AARP hopes so. Last week, the normally staid organization launched the Mom Means It campaign, which allows mothers to send light-hearted e-cards encouraging their adult children to buy insurance. One card, for example, features a pair tighty-whitie underwear.
“Shop for a health plan the same way you shop for everything ... online, in your underpants,” the card reads.
The campaign speaks to growing concerns that not enough young, healthy people will sign up for health insurance through the state health exchanges, which open for enrollment Oct. 1. The exchanges are a key part Affordable Care Act, which aims to provide health coverage to millions of uninsured Americans by 2014. The exchanges purport to offer low-cost insurance options, but there are still concerns that some people will find them too costly.
Renee Huard, 56, of Stonington, counts her 26-year-old son Brendan among that group. Though Brendan is still covered under his parents’ insurance, that will change when he turn 27 next September. And his mom is worried about what will happen. She said she’s pushed him to look into the exchange but he’s not interested.
“He’s resisting,” she said. “Kids that age — they’re not making much money.”
Taking a gamble
The insurance premiums on the exchange range widely depending on age, county of residence and which of the marketplace’s three insurers a customer uses. However, the base rates for individual coverage range from about $215 a month to around $346. Those who don’t get covered, either through the exchange or some method, will have to pay an annual penalty. But that cost seems fairly small in contrast to health premiums.
For 2014, the tax is $95, or 1 percent of an individual or small business’s income — whichever is greater. The tax rises to $325, or 2 percent of income, in 2015 and $695, or 2.5 percent of income in 2016. Some people are exempt from the tax, including those below a certain income and those who can’t afford the coverage that’s available.
For some young people — who might consider themselves invincible — paying the tax might seem the better alternative, said William Gedge, senior vice president of payer relations for the Yale-New Haven Health System, which includes Bridgeport Hospital, Greenwich Hospital and Yale-New Haven Hospital. Though the Affordable Care Act is supposed to result in more people with insurance and fewer people needing charity care, Gedge said he expects there will be those who opt out of the system, gambling that they won’t get sick or be injured.
“I think some healthy folks might just say ’I’m not going to pay that large amount for health insurance,’ ” he said.
That would be problematic for the exchange, said Angela Mattie, chairwoman of health management and organizational leadership at Quinnipiac University. For the model to be sustainable, she said, the majority of those who buy into it need to be healthy. “If only sick people jump into the pool and you don’t spread the risk around, then you’ll have a system that might not work,” she said.
Confident in coverage
But Kevin Counihan, chief executive officer of Connecticut’s health exchange, Access Health CT, is fairly confident that won’t happen. He said most young people understand the need for health insurance, pointing to a June poll from the Kaiser Family Foundation indicating that just a quarter of those 18 to 30 felt they were healthy enough to go without insurance. The majority — roughly 75 percent — of those who responded to the survey in this age group said insurance is something they need and about two thirds said they were worried about paying medical bills for a serious illness or accident.
“Irrespective of age, bad things can happen,” Counihan said. “If you get injured or hurt and you’re in the hospital, you’re going to be incurring some big bills.”
Renee Huard worries that will be the case for her son, whom she doesn’t think can afford to go without insurance. Brendan works at a construction job with no insurance benefits. Last year, he had a serious car accident and ran up $250,000 in medical bills. Huard said her son’s injuries required a wide array of procedures, and a stint at the premiere rehabilitation facility Gaylord Specialty Healthcare in Wallingford. Huard said her son is now considered healthy, though he had been denied coverage in the past for various reasons, including allergies and asthma. She said she’s still not sure what he’s going to do, and the uncertainty worries her.
“You get one bad thing happen to you, and you’ll be paying the rest of your life,” she said.
In fact, Counihan said, bypassing coverage and paying the tax might actually be more expensive in the long run. Counihan said the base insurance rates don’t reflect the tax credits and other discounts many state residents will be eligible for through the exchange. Some residents might also be eligible for free coverage via Medicaid, depending on their household income.
Still, Gedge said, due to the fact that many hospitals will perform charity or uncompensated care to people who are uninsured and can’t pay, he expects there will be people who believe they just don’t need the exchange. Indeed, the Congressional Budget Office projects that, by 2016, 3.9 million people will be paying the penalty.
That’s why organizations like AARP are launching efforts to send home the message that coverage is important.
The e-cards are a gentle way for parents to get their children to be proactive when it comes to health care, said Nicole Duritz, national AARP vice president of health education.
The Affordable Care Act is so complex and has become such a political hot potato that some people, including young adults, might have gotten intimidated by it all, she said. The card campaign humanizes health reform, while also making a point about the importance of coverage.
“This is not about politics — it’s about people,” she said. “It’s about arming people with information about what this law means to their lives so they can make decisions.”
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