Here & Now

ACA In Wisconsin: Young Invincibles

Frederica Freyberg:

But first, healthcare.gov. That’s the website that is still overloaded and for many inaccessible. People are upset about it, including President Barack Obama.

Barack Obama:

There’s no sugarcoating it. The website has been too slow, people have been getting stuck during the application process, and I think it’s fair to say that nobody’s more frustrated by that than I am.

Frederica Freyberg:

And so the president this week pledged an intensified effort to fix the site. Once the uninsured or people looking to switch plans can get on to compare policies, there’s one group insurerers sure hope sign up. They’re the so-called young invincibles. These are adults, age 18 to 34, who would generally be healthier and stronger, but they might also be less likely to think they need health care insurance despite the penalty for lack of it.

Georgia Curry:

Take a deep, deep breath in.

Frederica Freyberg:

25-year-old Georgia Curry is a college graduate and yoga instructor.

Georgia Curry:

Working as a freelancer in a lot of different areas, at different yoga studios and in fitness, and I need insurance. Grab your left ankle.

Frederica Freyberg:

She says she needs insurance by next year, when she turns 26 and is no longer on her parents’ plan. Curry acknowledges her work keeps her fit. She knows she’s young and healthy, but not invincible.

Georgia Curry:

You never know when you’re going to break your leg, if you’re going to get in a car accident. Like, you never know.

Frederica Freyberg:

In Wisconsin, 19% of 18 to 34-year-olds are uninsured. In Milwaukee that number is 26%. Statewide that’s 229,000 uninsured young people in that age group. Brian Burrell is the Midwest director of a national group called Young Invincibles which advocates for economic security, including the Affordable Care Act.

Brian Burrell:

Young adults are historically the largest uninsured age group. This is a huge shift and a lot of people are a little bit in the lower income and they're going to be able to qualify for some of those benefits. The big thing is really that we actually came up with the name because we’re not invincible. Young people, they're going to get hurt. They're going to get sick at some point, it's just a matter of when. When you compare looking at a premium that might cost you $100, $50 a month compared with a $10,000 broken bone, there’s a big difference, and it can give you some real financial security.

Frederica Freyberg:

But some young people just don’t buy it. 20-year-old Haley Sinklair is a UW-Madison student active in Young Americans for Liberty, staunchly opposed to the new health care law.

Haley Sinklair:

You are being taxed or fined if you don’t sign up for health care and that’s frustrating because never have we had something like that where you're mandated for health care..

Frederica Freyberg:

Under the Affordable Care Act the penalty for an individual not having insurance is $95 in 2014. It goes up to $325 in 2015 and $695 in 2016.

Georgia Curry:

I would like to pay a really low premium.

Frederica Freyberg:

According only to estimates, because she couldn’t get into the online marketplace, Curry’s insurance premium for 2014 for a mid-tier plan would be $2,428 a year, but because of her income, she could get a government tax credit of $2,188, making her premium $240 a year.

Georgia Curry:

I know some people who I would venture to guess will not buy insurance the first year and pay the penalty. But as the penalty increases year to year, I think you get to a point where it’s worthwhile to just pay and have the coverage.

Brian Burrell:

It’s a choice that people think that they’d rather pay the penalty, they can definitely do so. But I think especially starting in 2016 the penalties will actually be quite a bit higher. It'll be a minimum of $700. In some instances, when you're going to get enough tax credits, it could actually be cheaper just to buy health insurance.

Frederica Freyberg:

So the push is on, and built into the law to incentivize 18 to 34-year-olds to enroll in the marketplace. We asked US Department of Health and Human Services regional director Kathleen Falk about it. How important is it to get this young healthy demographic though into the kind of group?

Kathleen Falk:

Well, sure it’s important to help a bigger pool so we all pay lower rates. We all have some skin in that game. But it’s also important because of their health.

Frederica Freyberg:

Insurers and providers in the marketplace acknowledge they want the young enrollees.

Michael Richards:

The big demographic that we’re trying to attract here with the marketplace is the young invincibles, as we call them, those people that need to get health insurance, but, you know, may not have the chronic illnesses that somebody maybe in the Medicare age group does. You know, just because they’ll have insurance doesn’t mean they’ll need that care.

Frederica Freyberg:

Haley Sinklair says she opposes the premise.

Haley Sinklair:

So I have to try to find a job to pay off my student loan debt, but pay as exorbitant amount for these new health care premiums, which will rise for young people because we’re the ones covering everyone else.

Frederica Freyberg:

So what happens– This is what supporters always talk about. You are crossing University Avenue and get hit by a car and you break your leg. What then?

Haley Sinklair:

Then I have to deal with those consequences, because I made that choice, as an individual to go uninsured. I have to deal with the expense. If I have to go into debt again after college, I have to. That’s my individual responsibility.

Frederica Freyberg:

A 1986 law requires hospitals to provide care to anyone needing emergency health care treatment regardless of ability to pay. The new Affordable Care Act is designed to reduce that most expensive kind of treatment by incentivizing primary and preventive care. Because emergency room bills add up fast and certainly not all of those charges incurred by even the best-intentioned but uninsured young invincibles would or could be paid.

Georgia Curry:

I live paycheck to paycheck pretty much.

Frederica Freyberg:

So for people, like Georgia Curry, working jobs that offer no insurance

Georgia Curry:

I don’t want to take the risk of not having insurance.

And really reach, reach like crazy.

Frederica Freyberg:

But salaries that can hardly withstand the high cost of emergency care, buying into the marketplace is the preferred position.

Georgia Curry:

Exhale, hands to the mat, step back, take a flow.

Frederica Freyberg:

Some people anxious to sign up for insurance through the marketplace have taken to paper applications. Meanwhile, secretary of DHHS, Kathleen Sebelius, announced this week that the department is launching a tech surge to try to fix the website.