Grads grapple with health insurance
Jose Arroyo, a graduating biochemistry major at the University of California, Davis, is feeling the pressures of his last days in college. This week, he departs academia for the real-world pursuit of making a living and attempting to shoulder responsibility for his own well-being.
As he completes final exams, Arroyo finds himself distracted by such seemingly mundane matters as health insurance – a concern that only came into focus, he said, when the university sent him an e-mail warning that his school-sponsored health coverage would soon expire.
That's when Arroyo, who has had few health worries, phoned home with concern.
"Some people, when they get out of college, are in a rush to find a job because they are thinking about buying a new car," said Arroyo. "For me, it's about health insurance."
The recession has quashed hopes for many young people looking to enter the work force. And health care advocates worry that thousands of college and high school seniors are graduating this year into the ranks of the medically uninsured, further burdening a system already under stress.
That's adding urgency to efforts to overhaul the country's health care system and provide better – and affordable – access to doctors and medicine.
Statistics show that young adults are the most likely to go without health insurance, making up nearly a third of the country's 46 million uninsured. In 2007, 13.2 million Americans ages 19 to 29 were uninsured, according to the Commonwealth Fund, a New York-based health-policy think tank. Last year, the fund published a study on the health insurance "rite of passage" faced by millions of young adults.
"This age group has the highest rate of accident-related visits to the emergency room, the highest pregnancy rate, the highest HIV rate," said Sara Collins, a co-author of the report.
Health care advocates argue that health habits learned at a young age and access to health care help reduce the risks for ailments as a person ages – and, in turn, cut costs.
"We want to make sure we don't have a population of people with chronic health conditions by the time they're 50," Collins said.
Recent high school graduates who do not go on to college are at a distinct disadvantage. The jobs available to them typically have low pay and few benefits.
Nearly two out of every five high school graduates who don't enroll in college are uninsured at some point during their first year out of school, according to the fund report.
Many remain uninsured years later. The study found that 39 percent of those ages 19 to 23 who don't attend school or do so only part time are uninsured.
Children typically can remain on their parents' health plans until they turn 19, unless they enroll full time in college. But even full-time students are eventually pushed off their parents' plans, many by age 23.
Legislation that seeks to extend that age to 27 is stalled in the Assembly's Appropriations Committee.
"Young people have high hurdles for getting coverage. They typically have lower incomes and are at jobs that don't provide health coverage," said Anthony Wright, executive director of Health Access California. "It is one of these ironies that one of the rites of adulthood is becoming uninsured because people lose their group coverage that they relied on when growing up."
As businesses struggle to contain costs, many look to cut expenses by whittling away at benefits, including company-sponsored health plans. With their premiums rising, many companies expect employees to shoulder a larger share of costs.
An increasing number of businesses, particularly smaller ones, are eliminating health benefits altogether.
With diminishing employer-based options, more people are relying on individual insurance coverage. Many such policies have low monthly premiums, but the deductibles can be in the thousands of dollars, leading some to forgo medical care or drop health coverage altogether.
"The key issue is this age group's concept of invincibility," said Vinny Catalano, area vice president for Gallagher Benefit Services, a national insurance broker. "Most eschew it because of cost. Young people have other things they prefer to spend money on. It's not that insurance is necessarily hard to get, but people in that young age bracket simply choose not to participate."
Hillard Chiu, 22, a UC Davis sociology student, understands.
"Being young and healthy, you think you're invincible, so there isn't a lot of concern about health insurance," he said. "Right now, I'm just thinking about my financial situation and how I can support myself. Health insurance is secondary."
Arroyo, 25, is enrolled in the University of California's Student Health Insurance Plan, established eight years ago because of the alarming rate of students – about two in five – who were entering the university system without adequate health insurance.
What's more, about a fourth of those who dropped out of college did so because of medical reasons, much of it linked to inadequate health insurance, according to a UC report drafted then.
Coverage under the university health plan typically runs out a few months after graduation. Students are then on their own to find new coverage.
At California's state universities and community colleges, students do not have the option of school-sponsored health plans but have access to health clinics that offer routine care. They are on their own to find comprehensive health coverage if they aren't covered by their parents' policies.
The prospect of expensive medical bills motivated Arroyo's call home. His father assured him he would not go uninsured.
Though relieved, "it makes me feel bad that they're going to have to pay for it. I know health insurance is really expensive right now," Arroyo said.
"I never really thought about it because I never get sick. I've never broken anything."
Still, he said, "You never know when you'll get into an accident."