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Commonwealth Fund: Young Adults Defer Health Care Due to Costs

By Dena Bunis, CQ HealthBeat Managing Editor

May 26, 2011 — More than 600,000 young adults have become insured since the health overhaul law allowed them to stay on their parents' insurance plans until age 26. But a new Commonwealth Fund study also found that many of those ages 19 to 29 are going without care because of cost.

The study found that in 2010, 45 percent of young adults did not fill a prescription or go to the doctor when sick or skipped a test, treatment or follow-up visit because of the cost. That's up from 32 percent in 2001.

The Commonwealth Fund used data from its 2010 Biennial Health Insurance Survey to prepare the report. It also found that 40 percent of young adults had problems paying medical bills, had been contacted by a collection agency over unpaid bills, had to change their way of life to pay medical bills or were paying off a health care debt over time.

The provision in the health law that allows parents could to keep children on policies longer was one of the most popular and is often cited by overhaul supporters as something the Republicans would take away under their proposed repeal of the law.

The provision has made a difference, according to a May 5 Gallup Poll that showed uninsured rates among 18-to-29-year-olds fell in the early part of this year.

But the provisions for families will not solve the entire problem of insured young adults. Commonwealth reports that nearly half of these uninsured—7.2 million—are in families with incomes about one third above the federal poverty level and another 4.9 million have incomes between one-third and four times the poverty line. Those families are less likely to have insurance, particularly policies that include dependents.

But under the health overhaul, the study points out, young adults in those economic groups will either qualify for the Medicaid expansion or for federal subsidies to help them pay for insurance.

Another aspect of the law will provide better insurance for college students, the report points out. Beginning in 2012, college health plans will have to follow most of the same rules that private health plans do, such as the elimination of lifetime coverage limits and rescissions and the phasing out of annual limits. Commonwealth estimates that 1.6 million young adults enrolled in college and university plans will have better coverage once that change takes effect.

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