Most of us know someone like Blake Sisney.
By DONALD BRADLEY and SCOTT CANON
The Kansas City Star
Hes 27, healthy, no insurance, never gets sick, never goes to the doctor. And like some of his millennial kin, he is a bit resentful that the fate of this whole Obamacare deal is being dumped on his young shoulders.
He hasnt signed up. Hasnt even tried.
If its such a great thing, how come they have to force it on me? he asked as he tended bar at the Opera House Coffee & Food Emporium in the River Market.
This could be a problem. The website glitch for the federal health insurance exchange that weve been hearing so much about is just that a glitch. It will, presumably, be fixed.
But beyond that could lurk a far more complex problem and one harder to solve: Young adults might not view the Affordable Care Act with the same enthusiasm as, say, the latest phone.
What if they dont sign up? By all accounts, including government math, the 18-to-35 demographic is key to the success or failure of the ACA, commonly known as Obamacare.
The young, after all, are the sort of customers insurance companies need because theyre less likely to make claims on their policies. They will help offset the cost of caring for older, sicker people much more eager to sign up especially because insurers can no longer reject them.
But the young are also typically healthier and less worried about medical bills than older folks, so they may be less motivated to fork over cash for a monthly insurance premium.
And they tend to work in jobs less likely to come with insurance packages. As of October 2012, according to the Kaiser Commission on Medicaid and the Uninsured, 38 percent of the 45 million-plus uninsured in the United States were between the ages of 19 and 34.
If Sisney were to experience catastrophic injury or illness, he said, his family would help. But he acknowledges that not everyone has that safety net.
I know its probably a good thing for the country, so Im sure Ill get around to checking it out, he said of Obamacare. Whats that date again?
That would be the Dec. 15 deadline for coverage to begin Jan. 1. Those who dont apply by March 31 will face a fine on their taxes in 2014. Penalty amounts could be as low as $95 or 1 percent of the persons income, whichever is greater. Those numbers, however, ratchet up steeply in subsequent years.
Tiffany Miller, 31, a student at the University of Missouri-Kansas City, said she might pay the penalty rather than participate in something she finds ideologically distasteful.
Coming up with a program that gives everyone insurance might be a good thing, but they dont stop there, she said. Some of that money I pay will probably go to someones abortion and that goes against my beliefs.
Obamacare falls under existing restrictions that prevent the use of federal dollars for abortion services except in cases of rape, incest or when the life of the woman is endangered. Consumers can buy policies on the health insurance exchange either with or without abortion coverage.
The website glitches work for Miller.
I hope they dont get it fixed, she said. I hope it stays down because I dont like the government telling me what to do.
Anger. A sample of Kansas City streets turned up some of that. Also complacency, apathy and jubilation.
Sarah Bopp, 32, a shift manager at Cafe Gratitude, loves what the ACA is designed to do.
Im all for it, she said. I listened to all the debates, kept up and made a decision that this is good for everyone.
Most of her friends feel the same way, she said. They have always wanted insurance, but if employers dont provide it, they cant afford it. Private coverage for herself, Bopp said, would run $350 or so a month.
Thats half my mortgage, she said.
Cody Foster, 21, a tire man at Jewels Service on Blue Parkway, thinks the ACA will work for him. He hasnt signed up yet because Im working 10 hours a day.
He understands the apprehension.
Right when this whole thing started, the government shut down. So what were people supposed to think? he said. Im sure a lot of people are holding back.
Obamacare? One young man said hed never heard of it.
At the Kansas Health Institute, spokeswoman Lisa Jones said its hard to predict a sign-up rate.
For young adults who reach that age when they cant stay on their parents insurance any longer, are they going to have that oh-no moment or are they just not going to worry about it? she said.
Most millennials told The Star that regardless of like or dislike, they would probably fall in line and sign up.
Younger Americans, generally more liberal, are more likely to support President Barack Obamas singular legislative achievement. A mid-October poll by Gallup found adults 18 to 29 more likely than middle-age and older Americans to approve of the health care law.
They are also the only age group more likely to approve than disapprove: 51 percent backing Obamacare and 44 percent not, Gallup noted.
But the war rages on.
Conservative groups continue to argue to those younger than 30 that Obamacare is a bad deal for them. Generation Opportunity in September released a Web video showing a creepy Uncle Sam showing up in the exam room of a nearly naked woman who received insurance under Obamacare. It was intended to suggest that the new program will come between patients and their doctors.
The group is also emphasizing cost.
The administration is trying to force a really bad deal on young Americans, said Evan Feinberg, the groups president and a former aide to Republican senators Rand Paul and Tom Coburn. We want to them to make the best possible health care decisions for themselves.
The better choice, the group contends, is to shop for health coverage outside insurance exchanges.
On the other side, Enroll America dismisses the notion that young consumers would fare better outside the exchanges. For starters, they may take a financial hit: Only those who use the governments marketplace can qualify for the tax credits that might offset the cost.
Enroll America spokeswoman Jessica Barba Brown also argued that difficulty in finding adequate and affordable insurance drove the creation of the system in the first place.
The group is spending $5 million on online ads and social media campaigns, much of it directed at getting younger adults to sign up for coverage.
She views the fumbled launch of the governments website as a temporary mess.
When the website is fixed, it will be vastly easier to get insurance from the exchanges than anywhere else, she said.
Anne Johnson, executive director of the pro-ACA group Generation Progress, said surveys show that young adults generally approve of Obamacare.
Its obvious that conservative groups smear campaign against Obamacare is not registering with young Americans, Johnson said on the groups website. Obamacare provides affordable and quality health care to all and millennials clearly understand the benefits and added protections they will receive under the law.
Coverage purchased outside the exchanges may cost less, but because it falls short of the standards set by Obamacare. Consequently, those young policyholders could still be subject to federal fines. Such plans will be available for purchase only until Jan. 1, with the exception of rare grandfathered policies already held by individuals or employers.
In the Kansas City market, a 28-year-old nonsmoker could pay from $100 to more than $140 a month for a midlevel plan through the Obamacare exchange. But that plan would be guaranteed to cover a wider variety of health care bills than policies purchased outside the exchange. And people with lower incomes would qualify for tax credits to cover part, or all, of the cost.
Missouri and Kansas decided not to expand Medicaid to cover more of their residents. And because both legislatures have been hostile to Obamacare, theres no state push to sign up the young. Get Covered Illinois, by contrast, is a $33 million campaign that includes the monitoring of Twitter and other social media to encourage that states youngest adults to buy health insurance through the federal exchanges.
Still, analysts say the demographic some call young invincibles emboldened by the vigor of youth and unable to imagine themselves buried in medical bills might calculate that the cost of premiums outweighs the odds of illness or injury.
Clint Looper, 26, who came from a farm in North Carolina to attend law school at UMKC, hasnt attempted to enroll on the healthcare.gov website. He doesnt like the ACA largely because to his thinking it does little to address the high costs of health care.
It just spreads it around, Looper said.
Once a Democrat, he said he became a Libertarian after taking a political science class.
There are few things the government does well, Looper said. The overall intent of Obamacare is good. They tried to help people, to make insurance affordable.
But programs that help people, that give something to someone, are not sustainable.
Sisneys sister, Michelle, is still on her parents plan but will opt out soon. She is skeptical of anything with such lofty aims as the ACA.
It might be a great thing, she said. But the hippie in me says there will be karma with the good will come a big, fat negative.
Sarah Bopp, though, is certainly willing to give the ACA a shot. Her frustration is strictly with the website. She has tried repeatedly to get on and pick a plan.
Its time for me to see how this works for me and my life.