Steven Binko is young. He’s healthy. So he doesn’t see any reason he should be required to have health insurance. “I’m not in a position to afford any insurance at all,” says the 25-year-old Los Angeles resident who is unemployed. He has coverage through his stepmother’s plan, but he’ll be forced off it when he turns 26 in February. After that, he’ll just do without. “For young people just learning to take care of themselves, it’s foolish we have to take care of our older generation,” he says.
Young invincibles, which is what the insurance industry calls people like Binko, are at the center of a pitched battle between backers of the Affordable Care Act and its opponents. There are an estimated 15.7 million Americans age 19 to 29 who lack insurance, according to the Commonwealth Fund, a New York-based foundation that works to expand access to health care. The White House has said it needs 2.7 million young adults to buy insurance through the government-run marketplaces that open on Oct. 1. Without this group, premiums for seniors with costlier health problems will rise, and the health-care reform may falter.
The conflict is playing out on television and the Internet, on college campuses, and in door-to-door campaigns waged by volunteers across the U.S. FreedomWorks, a group with ties to the Tea Party, is urging young adults to burn their “Obamacare draft cards” by skipping the exchanges. Americans for Prosperity, a conservative group backed by the Koch brothers that pushes for limited government, in July announced a $1 million ad campaign aimed at women and people under 35. “Obamacare is an awful deal for young people,” says Evan Feinberg, president of Generation Opportunity, an Arlington (Va.)-based advocacy group for 18- to 29-year-olds that supports less government. “We’re talking about stealing from young people during our leanest years. We don’t have the money to be footing the bill for older generations’ health care.”
Enroll America, an independent advocacy group led by a former Obama campaign field director, works with partners to educate college students about health insurance exchanges. In Texas, they’ve held more than a dozen back-to-college events and health fairs. In Florida, they’ve organized backpack giveaways. Campaigns on Twitter and Facebook (FB) have reached 2 million users, according to Enroll America. “All the research has shown that young people value health insurance and want it,” says Jessica Barba Brown, a spokeswoman for the group.
Young adults may balk at buying coverage because they are healthy and assume they don’t need it or because they can’t afford it. Either way, they will have to pay a penalty, which in 2014 will be $95 a year or 1 percent of household income, whichever is greater. “This demographic is critical,” says Caroline Pearson, a vice president at Washington consulting firm Avalere Health. Without them, mostly high-risk people gain coverage, and premiums go up. “It becomes a death spiral,” she says. If insurance rates climb because not enough younger and healthier Americans sign up for coverage, higher costs may lead to new attacks on the law.
It’s not yet clear who is winning over young Americans. About 56 percent of those age 18 to 29 said they approved of the law in a September survey by the Morning Consult, a Washington media company. When asked if they were almost certain or very likely to buy a plan on the public exchanges, about 35 percent said yes. Shane McClelland, 27, a family lawyer in Columbus, Ohio, who buys insurance on the individual market, is likely to go through an exchange. “I don’t have a problem paying my dues in society,” he says. “If it brings more people into having coverage, I’m OK with it.”
Others say the ads and outreach efforts aimed at young adults won’t sway them. Ethan Rutten, 21, of Davenport, Iowa, has insurance through a full-time job at Wal-Mart Stores (WMT) while he takes a year off from his studies at Augustana College. “It’s not fair that young people are being forced to help subsidize costs for older people,” he says. “I don’t think people should have to have insurance and be penalized if they don’t.”