by Olivia Golden, Executive Director of CLASP. View the full commentary here.
Earlier this month, President Obama announced that 8 million people have signed up for health insurance through the Affordable Care Act’s (ACA) exchanges; 28 percent (about 2.2 million) were between ages 18 and 34. Other young adults have gained coverage under the ACA by being added to their parents’ insurance (3.1 million youth under age 26, according to HHS) or by enrolling in Medicaid (an unknown share of more than 5 million new Medicaid enrollees are between 18 and 26).
The news media have covered all of these young people primarily as “cash cows” who will help finance other people’s health insurance. According to that narrative, the role of young adults is to subsidize the exchange by paying more in premiums than they incur in health care costs because they are healthier than older participants.
But focusing solely on financing ignores important benefits to young people, particularly those who are low-income. Meeting these young adults’ physical and mental health needs can help them succeed in school, in job training, in the workplace, and as parents. For example, a study on college completion found that 69 percent of students who did not graduate reported that having health insurance would have helped them “a lot” in getting a college degree.
The inclusion of mental health services in the ACA benefit packages is especially valuable. Among low-income young adults from high-poverty communities, unmet mental health needs stemming from trauma, stress, and exposure to violence are a key barrier to school and work success. This is particularly an issue for young adults of color, who are far more likely to live in communities of concentrated poverty where violence and trauma are prevalent. And while community organizations, schools, and job training partnerships can train staff to help some young adults, they depend on linkages to formal health care settings to provide intensive support to those who need it…
But perhaps the biggest omission in news stories painting young people as footloose and carefree is the large number of low-income young adults who are parents—and the correspondingly large number of young children whose early life is shaped by these parents’ caregiving. For example, a national sample of infants found that half of the babies living in poverty had mothers age 24 or under and another one-fifth to one-quarter had mothers between 25 and 29.
Prior to the ACA, many of these low-income young parents had no insurance coverage for their own physical or mental health after the birth of the baby. While a baby’s own health appointments could be covered by Medicaid or CHIP, as could a mother’s appointments during pregnancy, a typical state set Medicaid eligibility levels for mothers after delivery as low as 60 percent of the federal poverty level. Moreover, a non-custodial father would have no Medicaid coverage at any income level. Without Medicaid, options were scarce for young people working at low-wage jobs, which far too often came with no insurance.
Olivia Golden is the Executive Director at CLASP. Since 1969, CLASP has been one of the country’s most effective voices for low income people. This excerpt is part of a commentary series by Olivia Golden. View the full piece and sign up to receive future commentary pieces here.