Young Invincibles Want Health Care, Too

If you go to a health care town hall meeting, expect to see a lot of patriotic T-shirts and “Proud Grandma of ...” tote bags. Don’t expect to see anything from Forever 21. There are some notable exceptions, but generally speaking, town-hallers are old. Ask one of these senior citizens why the under-60 set is absent, and you’ll probably be told that it’s because young people just don’t care about the country. They really don’t even care about themselves; after all, 27 percent of them are uninsured! In July, Mark Steyn of the National Review articulated [2] why most people believe young Americans don’t have health insurance: “[T]hey’re 22 and [they think they’re] immortal and life’s a party.”

Steyn is taking a cue from health industry parlance, in which 18- to 29-year-olds are known as “young invincibles.” But not all of the 13 million young adults who are uninsured eschew coverage because they’re more wrapped up in hitting the bars than hitting the doctor’s office. Many of them aren’t insured because they don’t qualify for employer-based plans: They’re interning, working part-time, or working full-time at small companies, and they can’t afford individual insurance. But they’re uncomfortably aware that if they encounter health problems, the party’s over.

“The term young invincibles betrays an arrogance on behalf of young people that most people don’t really feel,” says Julia Smith, a founding member of the Young Invincibles, a coalition trying to inject younger voices into the health care reform debate. “All young people want insurance and know someone who’s paid the price” for being uninsured, Smith adds. The group’s website includes a Town Hall Survival Guide for young people who are willing to venture into town halls and pipe up among the senior citizens.

Young women are especially vulnerable to gaps in coverage. Even healthy women need regular access to health services for gynecological visits and contraceptives. A 26-year-old without insurance could find herself paying $800 a year or more for nothing more than an annual gyno exam, some standard lab work, and a prescription for the pill. If her nonprofit job pays $20,000 a year, $800 is a big chunk of change—maybe big enough to make her rethink that annual exam.

Many young people do skimp on care because it’s too costly. Fifteen percent of 18- to 29-year-olds haven’t gotten their teeth cleaned in the last year because they just can’t afford it. Seventeen percent went without needed medical services (prescriptions, doctors' visits, glasses, or mental health care) because they couldn’t pay for them. And young people know that if they get really sick or seriously injured, they’ll be financially ruined. “It’s almost become a joke,” Smith said. “When you’re going out to play pick-up soccer or Frisbee, it’s like, ‘Better not break a leg.’”

For Erin, 25, it was a cold, not a broken bone, that almost triggered her financial downfall. Two years ago, she came down with what she thought was "a little bit of a cold." Then she woke up in the hospital. According to doctors, she had called 911 and said she felt feverish and was having trouble thinking straight. When paramedics arrived, her temperature had skyrocketed, and she was in an “altered mental state.” She remembers none of this. She does remember being diagnosed with a blood infection, being released from the hospital after six days–and then returning within six hours. She had a severe reaction to one of her medications, which kept her in the hospital for another six days and left her with debilitating nerve damage.

As Erin started the recovery process—going to physical therapy, tracking down specialists who could help her—she realized that getting better wasn't going to be her only challenge. Getting her care paid for was a constant battle—one that she's still fighting. "It's been almost two years since my hospitalization and I'm still getting bills from it," Erin said. She's on the phone with her insurance company at least once a week. "I know that every time I go to the doctor, I'm going to have to spend an hour with the doctor and about two hours on the phone with the insurance company."

But among twentysomethings with serious health problems, Erin is one of the lucky ones. She had just started a new full-time job before her hospitalization, so she had health insurance. Her insurance was so fresh that she didn't yet have a copy of her insurance card when she was admitted to the emergency room, so she received the first bill for her two hospital stays. When the bills that said she owed her hospital $30,000 arrived, Erin says, she "looked at that and thought, "OK, that was a year of college. Or two weeks in the hospital."

The bills kept coming. Her prescriptions alone would have cost more than $600 a month without insurance. She takes seven pills a day, three of them to control her blood pressure and four to regulate the chemistry of her brain. Then there are also annual tests, quarterly appointments with her primary care doctor, and twice-weekly trips to a physical therapist.

Despite the struggles she's had with her insurance company (it initially refused to pay for her ride to the hospital because the ambulance the 911 operator dispatched to her house was from an "out-of-network" fire department), Erin is grateful for her coverage. "Going to these specialists without this insurance would be absolutely impossible," Erin said. She pays her insurance premiums two months in advance to make sure that her company never has a pretext for denying her coverage (and asked us not to use her last name so her insurance company wouldn’t know she’d spoken about her care publicly).

Given her experiences, Erin says it’s frustrating to listen to pundits talk as though young people neither need nor want health care. So she’s excited by the efforts of people like Julia who have dedicated themselves making health care reform happen. The Young Invincibles website is full of not-so-subtle reminders that being young doesn’t necessarily mean being healthy (it features photos of crumpled bikes, pregnant bellies, and anxious-looking dentists). But they know that just telling recent grads to get themselves insured isn’t going to do any good. They also have to remind lawmakers—who thus far have heard from more people with AARP cards than Facebook profiles—that under the current system, the many twentysomethings who know they aren’t invincible still find health care unattainable.