Young Californians, Unite! More on the Manifesto…

Over on the Sac Bee Crossroads blog on Healthcare, I refute the much-cited argument (by many, not just by Assemblyman Richman) about young people not caring about being insured:

So let me be the one confront one of my pet peeves, blaming young people to provide justification for an individual mandate: Here’s this quote from the opening essay by former Assemblyman Richman: “Young healthy adults, 18-34 years old, are the largest single demographic segment of the uninsured and account for about 40% of uninsured adults. This population with low health care needs collectively believes it is not economically worthwhile to purchase costly insurance.”

He’s right that young people are more likely to be uninsured, but wrong about the reason. It’s simply not supported by the data, which shows:
* Young people are more likely to be low-income, just starting out their careers.
* They are more likely to work at jobs that do not provide health coverage to their workers (McDonald’s, Wal-Mart, etc)
* They are more likely to be in the first several months or years of employment, and thus not qualify for their employer’s health benefits.
* They are less likely to qualify for Medicaid, since they are less likely to have dependant children at home.

These are the reasons young people are more likely to be uninsured, not because they don’t want it. The most recent CHIS (California Health Interview Survey) data shows that when offered, young people take up coverage at the same rate as older people. They have similar rates of uninsurance if you account for income and job type.

Yet the mythical problem of the “young invincible” leads policy folks to propose an individual mandate, which as we have written (in a paper on the Health Access website) is not just unwarranted, but unworkable and unwise. (

Most importantly, miscasting the problem leads to unfortunate solutions. We should be focused on systemic changes to extend dependent coverage, get more employers to provide health coverage, to expand public insurance programs, or to create a universal system like Medicare or the VA. Young folks get this: they overwhelmingly supported Prop 72, because they see themselves or their friends working but not having coverage, and the consequences, even for those that are healthy. Young people aren’t the problem, they are the solution.

Twenty-somethings are the base support for any health reform, and they need to be engaged and active in this debate.

Part of a young people’s health agenda would be extending dependent coverage. Speaker Nunez sponsored such a bill in 2005, one that Health Access California supported, with some interest from groups like Rock the Vote. Other states, most recently New Jersey and Massachusetts, have raised the age that a dependent child can stay on their parents’ health insurance. With young folks seeking more education and otherwise staying at home longer, it’s a small but important step.

Our 2005 bill summary shows the fate of the bill, AB1698(Nunez): it was vetoed by Governor Schwarzenegger. We’ll see if this is another idea that he may reconsider, as part of a broader package.

Health Access California promotes quality, affordable health care for all Californians.
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