November 2, 2013

Young people, the key to Obamacare, ponder whether to enroll

Young adults might not view the Affordable Care Act with the same enthusiasm as, say, the latest phone. What if they don’t 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 they’re less likely to make claims on their policies.

Most of us know someone like Blake Sisney.

He’s 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 hasn’t signed up. Hasn’t even tried.

“If it’s 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 we’ve 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 don’t 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 they’re 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 it’s probably a good thing for the country, so I’m sure I’ll get around to checking it out,” he said of Obamacare. “ What’s that date again?”

That would be the Dec. 15 deadline for coverage to begin Jan. 1. Those who don’t 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 person’s 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 don’t stop there,” she said. “Some of that money I pay will probably go to someone’s 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 don’t get it fixed,” she said. “I hope it stays down because I don’t 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.

“I’m 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 don’t provide it, they can’t afford it. Private coverage for herself, Bopp said, would run $350 or so a month.

“That’s half my mortgage,” she said.

Cody Foster, 21, a tire man at Jewel’s Service on Blue Parkway, thinks the ACA will work for him. He hasn’t signed up yet because “I’m 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. “I’m sure a lot of people are holding back.”

Obamacare? One young man said he’d never heard of it.

At the Kansas Health Institute, spokeswoman Lisa Jones said it’s hard to predict a sign-up rate.

“For young adults who reach that age when they can’t 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 Obama’s 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 group’s 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 government’s 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 government’s 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.

“It’s obvious that conservative groups’ smear campaign against Obamacare is not registering with young Americans,” Johnson said on the group’s 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, there’s 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 state’s 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, hasn’t attempted to enroll on the


website. He doesn’t 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.”

Sisney’s 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.

“It’s time for me to see how this works for me and my life.”

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