By Karen Pallarito
Day one of a five-day series
MONDAY, Sept. 23 (HealthDay News) -- Few uninsured young adults know about the state health insurance exchanges opening for business on Oct. 1, surveys show. But even if they did, would they snap up health coverage?
The answer to that question is one of the great unknowns as states prepare to roll out the exchanges, or marketplaces, which are a key feature of the Obama administration's health reform law.
Millennials' participation in the insurance exchanges is considered crucial to the success of the Affordable Care Act, which requires that most Americans get health insurance or pay a fine.
Insuring young, healthy people helps balance out the risk of covering older, sicker adults, experts say. But if America's 20- and 30-somethings don't sign up, the fear is that premiums could spiral out of control.
Opponents of "Obamacare" say young adults will end up paying higher premiums once the law takes effect.
A study by the National Center for Public Policy Research, a Washington, D.C.-based conservative think tank, found that millions of young adults would be better off financially if they went without health insurance and paid the fine -- $95 or 1 percent of income, whichever is greater, in 2014.
Estimates of young adult participation in the exchanges are all over the board.
"I think it's fair to say most young people will buy coverage if they consider it to be affordable and/or necessary, but until we see premiums, I think it's going to be really difficult for young people to assess whether this is affordable relative to all the other expenses they have," said Linda Rowings, chief compliance officer for United Benefit Advisors, an employee benefits advisory organization based in Indianapolis.
19- to 34-year-olds most likely to lack coverage
Young adults, ages 19 to 34, are more likely to be uninsured than any other age group, according to the U.S. Census Bureau.
"The vast majority (of young adults) who are uninsured say it's because they can't find affordable coverage, and that's one of the reasons we're really excited about the changes coming with the Affordable Care Act," said Christina Postolowski, a senior policy analyst for Young Invincibles, a Washington, D.C.-based national advocacy organization.
What's more, within the young adult population, certain demographic groups "could potentially benefit more," she added.
"For example, nationwide, the uninsurance rate for white 18- to 34-year-olds is 21 percent, but for Latinos it's 47 percent," she said, and for blacks, it's 33 percent.
Beginning in October, young people can use the new state health insurance exchanges to buy a private health plan, often with the help of federal tax credits, or enroll in Medicaid, if they qualify.