|Marital status and age are two
factors which correlate closely to the lack of health insurance
in the United States.
According to a report released last June by the National Center
for Health Statistics, married people are twice as likely to
have health coverage than people who have never married. A
spouse is three times as likely to have coverage than an
Age also plays a major role in
health insurance statistics. From January through March of
this year, nearly 30 percent of young adults between the ages of
18 and 24 had no health coverage.
It is hard to tell whether the
lack of health care protection for young adults is attributable
to their age or to their marital status since the large majority
of people under 24 years of age have never married.
Unless or until a system of
universal health care is adopted in the United States, those who
advocate for more health coverage for more people will need to
look closely at those who are young and single if they want to
succeed in their mission.
Since most working-age adults
receive health insurance through their employers, any plan to
get more 18-24 year-olds covered will need to focus on expanding
workplace benefits programs. And since most employers are
struggling to control the rising costs of health care benefits,
a successful strategy to expand coverage will need to address
the financial issue.
Since some of these young people
are cohabiting with an unmarried partner, expanding a workplace
benefits plan to include coverage for domestic partners will
help get health coverage for a segment of this uninsured
About 8,000 employers in the
United States now provide domestic partner health benefits.
They report that, on average, a two percent increase in costs
when these programs are implemented.
But the overwhelming majority of
young adults are not cohabiting. So what can be done to
encourage employment-based health coverage for them?
Elected officials in two states
-- Utah and New Mexico -- have enacted legislation to address this
Several years ago, Utah enacted a
law which extended the age at which "dependent children" were
entitled to health coverage through a parent's family health
plan at work. New Mexico enacted a similar law earlier this
Employers in these states may no
longer drop coverage for a worker's child when the child turns
18. Nor may they limit health insurance for those over 18
only if they are enrolled in college on a full-time basis.
In these two states, employers
must allow workers to keep dependent children on the company's
health plan until the child turns 26 years of age.
To keep employer's costs down,
Utah and New Mexico require parents to reimburse employers for the
extra cost associated with this extended coverage. So
there is no real financial detriment to the employers.
Although the parents must pay a
monthly fee, the cost of coverage for their children through an
employer-sponsored group plan is much less than they would have
to pay for an individual policy for the adult child.
This type of a state mandate on
employers has several beneficial effects. More young
adults are insured, parents save money through a group plan, and
employers do not have to foot the bill. Taxpayers may also
benefit since fewer tax dollars will be spent on emergency room
medical services to uninsured residents of the state.
The California Legislature passed
a similar measure (AB 1698) only last month.
Unfortunately, Gov. Arnold Schwarzenegger decided to veto the
bill because it required employers to pay some of the cost of
the added coverage.
One wonders whether the
Governor's advisors carefully considered the legislative reports
which analyzed the beneficial fiscal effects of AB 1698.
A report issued by the California
Assembly noted that, according to the California HealthCare
Foundation, approximately 1.3 million Californians ages 18
to 24 are uninsured, representing 20% of the state's 6.5
million uninsured. It also cited data from the The
Commonwealth Fund showing that young adults (ages 19 to 29) are
one of the largest and fastest-growing segments of the
population without health insurance in the U. S.
Gov. Schwarzenegger is
desperately seeking ways to reduce state expenditures. Did
he not read that section of the Assembly report which suggested
that the state could save bundles of money if he had signed this
According to the Assembly
Appropriations Committee, AB 1698 would result in indeterminate
savings to the extent individuals receive dependent coverage
instead of enrolling in the Medi-Cal program. The
Appropriations Committee estimates that if 5% of the 525,000
individuals ages 19-25 currently on Medi-Cal received
dependent coverage through their parent or guardian's
employer as a result of this bill, instead of enrolling in
Medi-Cal, full-year savings would be $55 million.
Perhaps advocates for reform and
business leaders in California can find common ground next year
and devise a bill which is closer to the models adopted in Utah
and New Mexico. If increased costs to employers were
removed from the bill, Gov. Schwarzenegger's prime objection to
AB 1698 would be eliminated, thereby increasing the chance that
he would approve the new version.
California is already leading the
nation in terms of domestic partner protections and benefits.
With a few fiscal adjustments, it could also become the largest
state to provide more health coverage for the young, single, and
Unmarried America 2005
Thomas F. Coleman, Executive Director of Unmarried America, is an
attorney with 33 years of experience in singles' rights, family
diversity, domestic partner benefits, and marital status discrimination.
Each week he adds a new commentary to Column One: Eye on Unmarried
firstname.lastname@example.org. Unmarried America is a nonprofit
information service for unmarried employees, consumers, taxpayers, and