Yet only one in four young people (27 percent) is even aware of the exchanges. And among those who were uninsured for a period of time in the prior year, less than one in five (19 percent) know about the exchanges, according to a recent Commonwealth Fund report based on a March survey.
However, the report noted, young adults recognize the importance of having health insurance. For example, more than two-thirds (67 percent) of 19- to 29-year-olds who are offered insurance through their jobs enroll in that coverage.
Millions also took advantage of a provision in the Affordable Care Act that became effective in September 2010, allowing young adults under age 26 to stay on their parents' health plans.
The findings "dispel the notion that young adults don't think they need health insurance," economist Sara Collins, vice president for affordable health insurance at The Commonwealth Fund, the New York-based health foundation, said at a recent media briefing. "Instead, affordability is likely a major barrier," she said.
One young adult's quest for insurance
Dennis Byrd, 26, is director of business development at a tiny start-up company in Rockville, Md., that doesn't yet offer health insurance to employees.
"It's something we've talked about; we just haven't jumped the gun on it yet," explained Byrd, who has had asthma since childhood. Byrd shells out about $50 a month just on inhalers.
In the interim, he's looking to buy his own coverage. He's priced individual policies starting at a low of $150 a month, but depending on the coverage, "it can drastically go upward, especially with a pre-existing condition," he said.
He recently learned about the insurance exchanges and hopes to find suitable, affordable coverage.
Starting in 2014, under the health reform law, health insurance plans can't refuse coverage or charge more because of a pre-existing condition. And young uninsured people like Byrd can use the exchange where they live to buy an individual health plan and potentially qualify for federal tax credits to help offset the cost.
Those subsidies are available to people who make between 100 percent and 400 percent of the federal poverty level. In dollar terms, that's $11,490 to $45,960 for an individual.
Millennials making more than 400 percent of the federal poverty level won't qualify for tax credits but may use the exchanges to shop for coverage. In states that have released information about health plan premiums, "rates are coming in relatively competitively," said Collins, the Commonwealth Fund economist.
Young people with very low incomes -- up to 138 percent of the federal poverty level -- may have still another option.
In 2014, 24 states and the District of Columbia will expand their Medicaid programs to cover low-income people, starting at age 19, based solely on income. If you're eligible, you will receive free or low-cost care and won't have to buy coverage through the exchange.