Twentysomethings who can bike up and down a mountain on two hours’ sleep and a can of energy drink still need health insurance.
Health insurers and producers are struggling to convey that message both to the members of Generation Y and to government officials.
Pitching something this abstract to healthy, poorly paid young adults who lack employer-provided health coverage is tough.
WellPoint Inc., Indianapolis, says those young adults see themselves as “the young invincibles.”
“I call them independent, active and fearless,” says James Scholl, owner of Scholl Associates, Denver, an insurance agent who sells temporary and permanent health coverage for young adults to the young adults and their parents.
But persuading lawmakers to take action in states with strict community rating laws can be even tougher.
In Colorado and other states with relatively loose pricing rules, young adults may be able to get high-quality major medical coverage for less than $100 per month.
In a state like Colorado, “health insurance is not too expensive for young people,” Scholl says. “The question is, Will they buy it?”
But the health policy advocates who have shaped the rules that govern underwriting and pricing in the community rating states have done so with older, sicker consumers in mind. The result is that older, sicker consumers in a state like New Jersey may pay just $400 per month for good coverage–but healthy young adults also may have to pay $400 per month for good coverage.
Meanwhile, the cost of administering COBRA and other state and federal laws is encouraging employers to drop health coverage or limit the scope of plans using rules that often shut out younger workers, Scholl says.
Older consumers tend to be sicker than members of Generation Y, but only 14.3% of U.S. adults in the 45-64 age group and 0.8% of U.S. adults age 65 and over lack health coverage.
Meanwhile, 26.4% of adults in the 25-34 age group were uninsured, and the percentage of adults in the 18-24 age group who were uninsured jumped to 31.4% in 2004, from 30.2% in 2003.
The rate of increase in the insured rate for the 18-24 age group was higher than that for any other age group.
The percentages mean that roughly 14 million young adults went without health coverage in 2004, even though most of them were in fine health and should have been cheap to insure.
Sometimes young adults do prove to be mortal.
In 2003, Michelle Morse, a 20-year-old college student, learned she was suffering from advanced colon cancer. She had health insurance as a dependent on her mother’s employer-sponsored health coverage, but she discovered that she would lose access to ordinary dependent coverage if she cut back on her course load to deal with her cancer.
AnnMarie Morse, Michelle Morse’s mother, would have had to pay $550 per month for COBRA continuation coverage for Michelle, on top of the $290 per month the family already was paying for its share of the employer-sponsored health coverage, according to AnnMarie Morse’s Website.
Michelle Morse died two years later without ever getting a chance to cut back on her course load.
AnnMarie Morse has started an effort to persuade New Hampshire lawmakers to pass a bill that would allow seriously ill college students to take breaks for medical treatment without losing access to dependent coverage through their parents’ policies. The bill is expected to become a law soon.
Since Michelle Morse died, lawmakers in several states have introduced “Michelle’s Law” bills–legislation that could require affected state-regulated health insurers to offer access to extra continuation benefits for young adults who are too old to get insurance through ordinary dependent coverage.
In New Jersey–a community rating, guaranteed issue state–insurers must offer access to continuation benefits for children until the children marry, have children of their own or reach age 29.
In Colorado, for example, carriers that offer any dependent care coverage must offer parents the ability to purchase coverage for unmarried children age 24 and under who depend on the parents financially.
Parents can buy dependent coverage for young adult children in Colorado even if they do not claim the children as dependents on their tax returns, according to the Colorado Division of Insurance.
So far, the Colorado benefits continuation law has not had a noticeable effect on insurance purchases, Scholl says.
America’s Health Insurance Plans, Washington, is skeptical about the young adult coverage access laws.
“Young adults tend to be uninsured more often than other socioeconomic groups,” says AHIP spokesman Larry Akey.
The government should play a role in supporting high risk insurance pools for young adults with serious, chronic health problems, and health insurers already are developing products to serve healthy young adults, Akey says.
But Akey contends that the New Jersey benefits continuation law and similar laws could backfire, by increasing the cost of health insurance in ways that push coverage even further out of reach of ordinary consumers.
Companies that have made a splash in the young adult health insurance market include Assurant Health, Milwaukee, and WellPoint Inc., Indianapolis.
Assurant Health, a unit of Assurant Inc., New York, has promoted the value of temporary health insurance as a tool for protecting recent college graduates and young workers who are waiting to qualify for employer-sponsored health coverage.
Meanwhile, WellPoint has jolted the young adult health coverage market by introducing the Tonik product family. WellPoint sells the products in California, Colorado and Nevada.
A WellPoint affiliate, Unicare, has introduced the Sound policies, which resemble the Tonik policies, in Texas and Illinois.
Blue Cross of California, a WellPoint subsidiary, introduced the Tonik policies in 2004 after focus groups helped the company study what young adults wanted and needed.
The main message was “it needed to be simple to understand,” says Sherry Jansen, a business development manager at WellPoint’s Blue Cross of California unit.
California Blue found that any product with a chance of succeeding in the young adult market also would have to offer a relatively modest deductible, along with no coverage for certain types of routine care, such as occasional visits to the doctor’s office or occasional trips to hospital emergency rooms.
WellPoint will sell Tonik to consumers between the ages of zero to 64 who want it, but most of the buyers have been young adults, Jansen says.
The product includes dental coverage, vision discounts, $20 to $40 co-payments for doctor visits, and up to $5 million in lifetime coverage.
WellPoint is holding down costs by excluding benefits for routine maternity care and for the types of routine screening tests that most young adults skip.
WellPoint also has put up an edgy Website for Tonik, and it lets young adults who qualify for Tonik coverage buy it immediately and print out their own identification cards.
In Colorado, Scholl is trying to develop a program that will use Tonik as the basis for a campaign to sell individual health coverage to seasonal ski resort workers.
One thing Scholl likes about the Tonik policy for his clients is the policy’s first-dollar ambulance benefits, for the times when “they go in one direction and their knee goes in another,” Scholl says.