By Elizabeth Stawicki, Minnesota Public Radio News
Sun, Aug 18 2013
MINNEAPOLIS, Minn. - Robert Bauer is young, lean and healthy - just the kind of person the government wants to buy into its new online health insurance marketplaces.
Bauer doesn't see the need. The 24 year old, a 2011 graduate of the University of Minnesota, works in organic farm fields three days a week, and prides himself on eating well. He's uninsured - health covereage just hasn't been part of his lifestyle.
"I just don't think it's worth the money for me to get health insurance at this point," he said.
He hopes that if he got seriously ill or had an accident his family would have the resources to help or "maybe I'd just lose my life,and that would be OK, just so other people wouldn't have to live the rest of their lives in poverty or bankruptcy."
While Bauer generally doesn't fear a health crisis, the people building insurance exchanges worry about Bauer and the millions of other healthy Americans whom they fear may simply opt out. The marketplaces are a key part of federal Affordable Care Act, also known as Obamacare. Younger, low-risk people are needed to offset the costs of covering older, sicker Americans.
"It's important for everybody to participate all of the time and to pay an average amount in premiums so that when something happens to one of us -- we have a baby, we get cancer... that will require thousands of dollars of care, the money is there in the pool," said Karen Pollitz of the nonpartisan Kaiser Family Foundation and a former Obama administration official. (Kaiser Health News is an editorially independent program of the foundation.)
The law requires Americans obtain health insurance or pay a penalty beginning in 2014. But some young people might just pay the penalty, which in the first year isn't much, the greater of $95 or 1 percent of income. The fee rises to $695 or 2.5 percent in 2016. While the ACA allows children to stay on their parents' policy until age 26, that doesn't help young people such as Bauer, because his mother is uninsured and his father is on disability. And, Pollitz notes, younger people are "systematically uninsured."
"We boot them off," Pollitz said. "We kick them out of Medicaid, (or) their parents' health insurance coverage just when they're starting off, just when they're not earning much and the odds are pretty low that they're going to get that first great new job with new benefits."
Young people aren't against being insured. A recent KFF poll found that about three quarters of 18-30 year olds believe having insurance is something they need and is important to have. The top reason younger people didn't have it: too expensive. But the law does provide subsidies for people earning up to 400 percent of the federal poverty line, $46,000 for a single person or $94,000 for a family of four. And, officials and advocacy groups are searching for ways to lure younger people in.