Steven Binko is young, healthy and recently unemployed. He doesn’t see any reason he should be required to buy health insurance next year.
Since losing his job at an Olive Garden restaurant in Jacksonville, Florida, the 25-year-old said he can’t afford to buy health care on his own. Even a premium of $40 a month for a plan through the U.S. Affordable Care Act exchanges would be too much. Therein lies the challenge for President Barack Obama.
Binko is one of 2.7 million healthy 18- to 34-year-olds, dubbed the young invincibles, that the Obama administration has said are needed in the exchanges to offset the cost of providing care for millions of other uninsured people who are likely to be older and sicker. Without young adults, who pay for insurance yet rarely use it, premium costs in the exchanges may soar.
“For young people learning to take care of ourselves, it’s foolish if we have to take care of the older generation too,” Binko, who now lives in Los Angeles, said in an interview.
Young invincibles are the focus of a pitched battle between Obamacare backers and the law’s opponents as the U.S. nears the Oct. 1 roll-out of government-run insurance exchanges. It’s a conflict playing out on television and the Internet, on college campuses and in door-to-door campaigns by volunteers nationwide.
“This demographic is critical,” Caroline Pearson, a vice president at Washington-based consulting firm Avalere Health LLC, said in an interview. “If you mostly have high risk people, premiums go up. It becomes a death spiral.”
If premiums can be kept low, Obama’s signature domestic policy achievement has a better chance of fulfilling its promise of affordably expanding health care to most of the nation’s 50 million uninsured people. If not, the costs may open fertile ground for new attacks on an overhaul that has been under siege by Republicans since it was signed into law by Obama in 2010.
“Obamacare is an awful deal for young people,” said Evan Feinberg, 29, a former Republican candidate for Congress who is now president of Generation Opportunity, an Arlington, Virginia-based advocacy group for young adults 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.”
Feinberg’s views have plenty of support.
FreedomWorks, an organization tied to the Tea Party, has urged young adults to burn their “Obamacare draft cards” by skipping the exchanges. Partnered with other groups, FreedomWorks is involved in outreach on college campuses and in surrounding communities, said Jacqueline Bodnar, a spokeswoman, in an e-mail.
At the same time, Americans for Prosperity, the Koch brothers-backed group that pushes for limited government, is spending almost $1 million on TV ads aimed at women and people under 35.
It’s not yet clear who is winning the hearts and minds of most of the young and healthy.
About 56 percent of adults ages 18 to 29 said they approved of the health law in a September survey by Morning Consult, a Washington-based media company. When those surveyed were asked if they were almost certain or very likely to buy a plan on the public exchanges, about 35 percent of the group said yes.
That number rose to 39 percent when they were asked if there was at least a 50-50 chance they would buy insurance through Affordable Care Act exchanges, according to the survey.
One reason for that support may be the subsidies offered under the health law. More than 80 percent of young adults who spent some time uninsured between March 2012 and March 2013 will be eligible next year for tax credits to offset premium costs or may qualify for the Medicaid programs for the poor, according to the Commonwealth Fund, a nonprofit research group.
Some, like Ethan Rutten, 21, of Davenport, Iowa, still aren’t convinced. He currently has health insurance from a full-time job at Wal-Mart Stores Inc. while taking a break from his college studies. He said he doesn’t think people in his age group should be required to have insurance.
“The cost of education is already so hard as it is,” Rutten said in an interview. “I don’t think people should have to have insurance and be penalized if they don’t.”
The challenge is how do you make young people see the value of having insurance at a time in their lives when they are least likely to use it and least capable of affording it.
“This population doesn’t understand why insurance is necessary,” Cheryl Smith, a health-exchange specialist at Deloitte Consulting LLP in New York, said in an interview. “It really is to protect your assets. When you’re young, you don’t have assets. You don’t worry about it.”
In February, Curtis Jones, 23, got sick and wound up in the emergency room. Because he was uninsured, Jones is now facing an $8,000 hospital bill he’s struggling to pay off.
He said he’s enrolling in Obamacare’s subsidized coverage because, “anything is better than nothing.”
Jones, who works part-time at a Home Depot Inc. store in Toledo, Ohio, said he makes $10.25 an hour and works about 27 hours a week. That may mean Jones would pay no more than $38 a month for insurance, the rate for those making less than $15,000 a year. Those earning $35,000 will pay no more than $273 a month, according to the Kaiser Family Foundation.
Enroll America, an independent advocacy group led by a former Obama campaign field director, is looking for people like Jones.
The group is working with partners on a “Get Covered America” campaign that is stretching across the country. An educational push on Twitter and Facebook has already reached 2 million users, according to the group.
“It’s about the value of health insurance,” Jessica Barba Brown, a spokeswoman for the Washington-based organization, said in a telephone interview. “All the research has shown that young people value health insurance and want it. The cost has put it out of their reach.”
In Texas, the groups backing Obamacare have reached out to young adults at more than a dozen back-to-college events and health fairs, Brown said. In Florida, they’ve held backpack giveaways, and in Ohio they held a press conference at Cincinnati State, a technical and community college whose main campus is in Middletown.
The goal of enrolling 2.7 million, young, healthy Americans is made even tougher by health reform itself, according to Deloitte’s Smith. The Affordable Care Act in 2010 extended the ability of youths to remain on a parents’ policy through age 25, trimming the number of uninsured younger adults to 15.7 million from 18.1 million.
“It’s a big chunk they need to get to enroll, and they’re fishing from a shallower pond,” Smith said.