A new report from the Commonwealth Fund says that American adults aged 19-29 are becoming one of the largest and fastest growing segments of the population without health insurance. From 2004 to 2005, the number of uninsured young adults (defined as adults in this age range) grew from 12.9 million to 13.3 million. While adults in the 19-29 age group comprise 17% of the non-elderly (under 65) population, they account for 30% of the non-elderly uninsured.
Young adults living in poverty account for a big part of this uninsured group. About 4 in 10 of uninsured young adults live in households with incomes below the poverty level. In addition, many employer-based health insurance policies cut off coverage for dependent children after they reach age 18 or 19 if the kids do not go off to college. (Many colleges require their students to have health insurance coverage, and employer-based health insurance often allows parents to extend coverage while their dependent children are enrolled.) Young adults who now choose instead to stay at home and take a job find fewer employers than before who offer health benefits.
An important factor influencing the availability of health insurance to this group, the report says, is the transient nature of young adult's lives. It is not unusual for college students--including those pursuing science degrees--to switch between work and school in order to earn enough money to pay for school or to gain new experiences. Their jobs, however, are often the low-pay or part-time variety that usually do not provide health insurance, and job tenure is often shorter for young adults than it is for older ones. So they risk going weeks, months, or years without health insurance.
A college degree is often cited as a key to avoiding poverty, but it provides no guarantee of health insurance coverage. Between 1996 and 2000, about 4 in 10 college graduates (38%) lacked health insurance for at least a little while in the year following graduation, more than half that number (21%) going 6 months or more without insurance. Graduated students are no longer covered by their parents' health plans or university-offered insurance. Their prospects for coverage depend on how quickly they can find a job that provides health benefits. Some students in the sciences have an advantage here, since jobs requiring science skills are more likely than many others to offer insurance coverage. But finding such jobs isn't easy, and often takes a while.
Consider, too, the postbac--the working hiatus many young adults take between undergraduate and graduate school described in this week's Science Careers. Some people manage to find good jobs with health insurance during this time, and those who participate in the Peace Corps, Teach for America, and similar programs typically are guaranteed coverage in various ways. But many students spend the postbac doing other types of work--tending bar, building houses, whatever they can find--and for them health insurance can be hard to find.
For postdocs, the situation has improved dramatically in recent years, but it's too soon to say the problem has been solved. While many science postdocs now have some form of health benefits, as Beryl Benderly pointed out a year ago in Science Careers, it is a fairly recent phenomenon, did not come without a struggle, and is by no means a uniform practice. Coverage varies from campus to campus and with the type of funding.
In this week's "Opportunities" column, Peter Fiske preaches the value of living in poverty and urges readers--young adults, mostly--to use the ability to exist on not much money as a way of increasing the impact they have on society. If you limit yourself to opportunities that pay a lot, he points out, you minimize the opportunity to have an impact on the world. It's a great way to think about things, but it doesn't take health insurance into account. Eating tuna from a can is no big deal, but taking a chance that a serious illness will drive you even deeper in debt is harder to dismiss. Because getting insurance is such a problem, some of our most creative scientists are, we suspect, forced to take the safe road and not the influential one. Instead of toying with a new idea and starting up a new company that in time will add millions to the nation's economy, they plug themselves into an existing slot where they can earn a good salary--and health insurance.
The report goes to describe why young adults need health care and the means to pay for it (consider pregnancy, HIV/AIDS, and obesity for starters) and discusses policy options for addressing the problem. An overview of the report is on the Commonwealth Fund Web site.
Hat Tip: Think Progress