Oct. 1, the day the exchanges mandated by the Affordable Care Act are scheduled to open, is fast approaching, and concerns for the success of this essential component of the health-care reform remain as strong as ever.
The key is the participation of young Americans. The Obama administration needs to convince young people, who are on average less likely to make use of medical services and therefore are cheaper to insure, to sign up for coverage on the superstore-like exchanges in order to balance out the older or sicker patients more likely to sign up for health insurance as soon as possible. Their insurance premiums are meant to cover the big bills for the relatively small number of sick people, allowing for theoretically affordable plans to be offered to all enrollees. The administration's fear is that young adults will continue to go uninsured despite the number of options the Affordable Care Act is creating.
ObamaCare's long-term viability has been the subject of much philosophical thought, number crunching, political debate, and economic analysis, so the expectations for the reform's success cover a wide spectrum. Of course several key polls, especially of young Americans, factor strongly into this debate.
Nearly every poll on ObamaCare has shown that support for the reform legislation is divided along party lines. A June Kaiser Family Foundation survey found that a majority of Democrats, 58 percent to be exact, are in favor of the Affordable Care Act, compared with 32 percent of independents and 12 percent of Republicans who have a similar view.
But that reading of general opinion gives a very limited perspective on how young people will respond to the insurance mandate. Young people are not as blasé about health insurance as is commonly assumed. Kaiser's health tracking poll gave some insight on this issue; it found that more than seven in 10 young adults, ages 18 to 30, said it was very important to them personally to have insurance.
Still, this strong stance among young people regarding personal insurance strips away the political nuances of ObamaCare. But it does seem to be an indication that younger generations of Americans believe more strongly that the affordability of health care is an important issue that may not be out of the government's domain.
A recent survey of 19- to 29-year-olds conducted by the Commonwealth Fund found that between 2011 and 2013, an increasing number of young adults "became aware of, and took advantage of," the Affordable Care Act's requirement that health plans offer dependent coverage for children through the age of 25.
As of March 2013, an estimated 15 million 19- to 25-year-olds had taken advantage of this policy and remained on their parents' insurance plan in the prior 12 months. Data from the Census Bureau confirms this finding; there has been a significant increase of insurance coverage in the young adult bracket that does not show up in other demographics.
More interestingly, while Republicans show intense dislike of the Affordable Care Act in polls, the Commonwealth Fund found that young adults who identified as Republicans enrolled in their parents' policies in greater numbers than young adults who identified themselves as Democrats, by a ratio of 63 percent to 45 percent.
Of course, the number of young adults taking advantage of this ObamaCare provision is higher among more affluent young adults and those with college degrees, who are more likely to have access to a parent's insurance plan in the first place. A different and more pressing question for the Obama administration is whether those young adults who cannot be covered under their parents' insurance policies will purchase plans on the exchanges beginning in October.
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