One concern of health reform was to get more young adults, ages 18 to 34, insured. A Deloitte survey of 500 people in this category looks at why they did and did not sign up. (Deloitte Survey) About 8 million people supposedly signed up for health insurance through the new exchanges. (I say supposedly because carrier information suggests that many haven’t taken the steps necessary to finalize enrollment, including paying premiums.) About 28% of these, or 2.2 million, were young adults. While the common perception is that young adults avoid health insurance because they believe they won’t need health care services, the survey suggests that cost is the primary factor. Among those who did not get insurance, 66% said they couldn’t afford it, 26% said the costs outweighed the benefits and 24% would rather pay for health care if and when they need it. (Multiple reasons could be given.) Only 19% said they were too healthy to need insurance. The most important reason given for getting insurance in this group was to avoid having to pay medical bills if they get sick, 67% (wait till they see their deductibles and copays); peace of mind, 60%, avoiding the fine, 49% and qualified for Medicaid, 40%.
Of the whole group, insured and still uninsured, only 55% ever visited the federal or a state exchange website. Of those who did visit an exchange, many had technical problems that either delayed their enrollment or caused them to cease trying. Awareness of some important aspects of the reform law is low; for example, about half weren’t aware of subsidies or the expansion of Medicaid eligibility. The most important factor for the 18-34 year-olds in choosing a plan are the overall amount that has to be paid, cited by 75%, good value, 68%, who is in the network, 48%, brand or reputation, 43%, and quality rankings, 38%. The most trusted sources of information are families and friends for 42%; health care providers for 30% and government agencies, 24%. Where do they get their information–25% say TV or radio ads, 17% say internet ads, 17% say newspaper ads and 11% say social media.
While insurance companies and the government would love to suck these young people into buying health insurance, for most of them it is a spectacularly bad deal. The vast majority have few health needs and when they do, they will be shocked by the deductibles and copays in their plans, which go on top of premiums. Their premium dollars are desired only to subsidize the much higher health costs of other age groups. No fairness or social justice in any of this.