OPINION: Insurance industry myths about the uninsured

Introduction

In 2007, a few months before I left the health insurance industry, I was tasked to write a “white paper” designed to help convince media folks and politicians that the problem of the uninsured wasn’t much of a problem after all. If demographic data was sliced just so, I was expected to write, it was easy to conclude that many of the uninsured — some 46 million at the time — were that way by choice.

I was told to point out, for example, that a significant percentage of people without coverage were in families with annual incomes of $75,000 or more. The implication: That those folks were simply shirking their responsibilities. A crucial fact that I was not to disclose, of course, was that many Americans, including wealthy ones, couldn’t buy coverage at any price because of pre-existing conditions. These are the “untouchables” as far as insurance companies were concerned. (That’s my term, not the industry’s. The underwriters prefer the term “uninsurable.”)

I also was expected to stress that most young adults — who comprise the largest segment of the uninsured — had chosen to “go naked” because they felt invincible. They simply didn’t want to pay good money for insurance because that cash could better be spent keeping the fridge stocked with Bud Light. To perpetuate that myth, we even came up with a catchy name for those twenty-somethings — the “young invincibles.”

Our message to America: Don’t feel sorry for those irresponsible bums, and by all means don’t let Congress pass any new laws that would require insurers to cover them.

Having to write that paper was one of the reasons I resigned. As the father of a couple young adults, I knew that their crowd did not consider themselves invincible. They simply did not have money left over after paying student loans and the rent to buy health insurance.

The reality is that young adults comprise not only the biggest segment of the uninsured population but also one of the heftiest segments of the unemployed population. While the overall unemployment rate rose slightly to 8.2 percent last month, the unemployment rate for 18-29 year-olds reached 12.1 percent, according to Generation Opportunity, a grassroots organizing group.

Fortunately, members of Congress did not fall for the insurance industry’s misdirection. Lawmakers included a provision in the Affordable Care Act allowing parents to keep their adult children on their family policies until they turn 26. It has become one of the most popular — and helpful — parts of the new law. As a study released Friday revealed, 6.6 million young adults — more than the entire population of my home state of Tennessee—are now insured because of that provision alone.

The Commonwealth Fund Health Insurance Tracking Survey of Young Adults found that between November 2010 and November 2011, an estimated 13.7 million people between the ages of 19 and 25 stayed on or joined their parents’ health plans and that almost half of them were able to do so because of the Affordable Care Act.

As the Commonwealth Fund noted, prior to passage of the law, most young adults were kicked off of their parents’ policies when they turned 19 unless they were enrolled as full-time college students. Those who didn’t or couldn’t continue their education past high school were out of luck. Many of the young adults who have been fortunate enough to find jobs work for employers that don’t provide benefits and don’t pay enough for entry-level workers to buy coverage on their own.

But as beneficial as the reform law has been to millions of families — mine included — it hasn’t been of help to young people who live in families with uninsured parents. The Commonwealth Fund survey found that nearly two of five young adults were without health insurance during all or part of 2011, primarily because they lived in low- and moderate-income households in which neither parent had coverage.

Further debunking the myth that young people remain uninsured by choice were some of the survey’s other findings. Of those young adults who were still uninsured last year, 60 percent said they had not gotten medical care they needed because of the cost. More than half of them reported problems paying medical bills or said they were paying off medical debts.

If the Supreme Court doesn’t invalidate the reform law this month, those young people, and those 26 and older, will be able to find more affordable coverage options through the expansion of both Medicaid and subsidies to purchase private insurance starting in 2014.

An organization that is trying to raise the awareness of coverage options that already are available to young adults (or that eventually will be) is the ironically named “Young Invincibles.” The “Friends With Benefits” page of the group’s website provides useful information and a tool kit with state-by-state information that every young adult and parent should check out.

Bottom line: Going naked is not as necessary as it used to be, thanks to ObamaCare.