|A new study reports that turning
19, or just after graduation from high school or college, are
major turning points in the lives of many Americans. It's
at these transition stages that millions of young people find
themselves without health insurance.
The issue brief, "Rite of
Passage? Why Young Adults Become Uninsured and How New Policies
Can Help," was released last month by the Commonwealth Fund,
a private foundation focusing its research on health and social
According to the report, nearly
14 million Americans between the ages of 19 and 29 were
uninsured in 2004, up 2.5 million from just four years earlier.
Some 40 percent of 19 to 23
year-olds who do not attend college lack coverage, usually
because they have been dropped as dependents from their parents
health plan at work.
About 20 percent of those who do
attend college full-time or part-time are uninsured while they
are in college, and the percent almost doubles as soon as they
graduate. For example, 38 percent of those who
graduated between 1996 and 2000 lacked coverage for at least part of the year following
Young people in poverty find
themselves dropped from their family's publicly-funded health
plan once they turn 19. They can no longer ride on the
coat tails of their low-income custodial parent for eligibility,
and low-income singles generally don't qualify unless they are
Many young adults from poor
families can't afford to attend college full time, so they wind
up working at low-wage jobs without health benefits. Some 43
percent of workers ages 19 to 29 who earn less then $10 per hour
"As a result of the combined
impact of such public and private insurance rules, uninsured
rates jump sharply at age 19," the issue brief notes.
"Turning 19 increases the risk of
being uninsured by more than twofold: the uninsured rate rises
from 12 percent among children age 18 and under to 31 percent
among those ages 19 to 29."
The report concludes that
low-income young adults are particularly vulnerable.
"Among those living in families below the poverty level, more
than half (54%) are uninsured."
Among employers who offer
dependent health coverage as a benefit, nearly 60 percent do not
insure dependent children over age 18 or 19 if they do not
To address this problem, some
state governments are passing laws requiring state-regulated
health plans to continue coverage for several years beyond 18,
regardless of the educational status of a dependent. New
Jersey, Colorado, Massachusetts, Utah, and New Mexico have
passed laws extending the age at which dependent coverage may be
The Commonwealth Fund does not
just complain about the health insurance problem of young
Americans. It offers three specific proposals to address
Congress could allow or require
states to extend coverage to those young adults in Medicaid and
SCHIP (State Children’s Health Insurance Program) who lose their
eligibility because of age, with federal matching funds
provided. A policy change such as this would help the 2.9
million uninsured young adults ages 19 to 23 with incomes under
100 percent of poverty.
State legislatures could pass
laws, similar to the handful mentioned above. Even if the
cut off age were only increased from 18 to 23 for dependents who
are not in college, this would provide coverage to an estimated
1 million young adults.
Finally, states could ensure that
all colleges and universities require part-time and full-time
students to have health insurance. Most private schools,
and about 25 percent of public universities, already have such a
requirement in place.
"Increasing the number of schools
that require students to have health insurance coverage and that
offer such coverage through state mandates could help cover the
1.9 million part-time and full-time uninsured students ages 19
to 23," the report states. "Federal or state subsidies for
premiums would help offset the costs of insurance coverage for
Millions of young people are
dropped from their parents’ policies or public insurance
programs at age 19 or on graduation day. They must
scramble to find insurance on their own as they make the
transition from high school to work or to college.
Turning 19 should be a cause for
celebration and eager anticipation of the challenges of
adulthood. For millions of young people it is, but for
millions of others it is a sobering reminder that, when it comes
to their health, they are truly on their own without a safety
The Commonwealth Fund has done a
public service by bringing this problem to our attention in such
a well-documented and thoughtful report. Their
recommendations deserve to receive careful consideration by
Congress and state legislatures.
Unmarried America 2006
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