THE COMMONWEALTH FUND Rising Numbers of Uninsured Young Adults: Causes, Consequences, and New Policies Jennifer L. Nicholson Associate Program Officer.

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Presentation transcript:

THE COMMONWEALTH FUND Rising Numbers of Uninsured Young Adults: Causes, Consequences, and New Policies Jennifer L. Nicholson Associate Program Officer The Commonwealth Fund October 14, 2008

2 THE COMMONWEALTH FUND 2 There Are 13.7 Million Uninsured Young Adults Ages 19–29, Almost 30 Percent of Nonelderly Uninsured, 2006 Note: Numbers may not sum to 100% because of rounding. Source: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May Analysis of the March 2007 Current Population Survey by S. Glied and B. Mahato for The Commonwealth Fund. Age 18 and under 20% Ages 30–35 12% Ages 50–64 15% Ages 36–49 23% Ages 24–29 16% Ages 19–23 13% Nonelderly uninsured = 46.4 million

3 THE COMMONWEALTH FUND 3 Uninsured Young Adults, Ages 19–34, in New York State and New York City, 2005–2006 Uninsured 27.1% Public 25.3% Individual 4.2% Employer 43.5% Source: D. Holahan, A. Cook, A. Williams, Health Insurance Coverage in New York, 2005–2006, United Hospital Fund, May Analysis of the 2006 and 2007 Annual Social and Economic Supplement to the Current Population Survey by the Urban Institute. Uninsured 25.4% Public 18.9% Individual 4.6% Employer 51.1% NY State = 4.0 millionNYC = 2.0 million

4 THE COMMONWEALTH FUND 4 Uninsured Young Adults, Ages 19–29, by Poverty Status and Race/Ethnicity, 2006 Less than 100% FPL 41% 100%– 199% FPL 31% 200% FPL or more 29% Other 7% Hispanic 33% African American 15% White 45% Uninsured young adults = 13.7 million Note: Numbers may not sum to 100% because of rounding. Source: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May Analysis of the March 2007 Current Population Survey by S. Glied and B. Mahato for The Commonwealth Fund.

5 THE COMMONWEALTH FUND 5 Young Adults Who Spent Time Uninsured During 2001–2003* *Young adults who were 19 to 23 in 2001 were followed over 2001–2003. Source: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May Analysis of the 2001 Panel of the Survey of Income and Program Participation by E. Gould for The Commonwealth Fund. Percent of young adults

6 THE COMMONWEALTH FUND 6 Months Uninsured Among Young Adults, Ages 19–23 and 24–29, 2001–2003 Population in millions Any part of 3-year period 13 months or more 25 months or more 36 months Total 19–23*17.362%33%17%7% Poverty <200% FPL >200% FPL Total 24–29*20.746%25%14%6% Poverty <200% FPL >200% FPL *People who were 19–23 or 24–29 at beginning of survey in Source: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May Analysis of the 2001 Panel of the Survey of Income and Program Participation by E. Gould for The Commonwealth Fund.

7 THE COMMONWEALTH FUND 7 Uninsured Children and Young Adults, by Poverty Level, 2006 Percent Uninsured Children Age 18 and Under Young Adults Ages 19–29 Total 12% 30% <100% FPL %–199% FPL1641 >200% FPL816 Source: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May Analysis of the March 2007 Current Population Survey by S. Glied and B. Mahato for The Commonwealth Fund.

8 THE COMMONWEALTH FUND 8 Insurance Sources for Young Adults, Ages 19–23, 2006 *Other includes Medicare, Medicaid, and Military. **Includes part-time students and non-students. Source: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May Analysis of the March 2007 Current Population Survey by S. Glied and B. Mahato for The Commonwealth Fund. Not full-time students** = 12.5 millionFull-time students = 7.6 million Own-employer 8% Employer- dependent 49% Individual or college plans 20% Other* 6% Uninsured 17% Other* 13% Employer- dependent 16% Own- employer 25% Individual or college plans 7% Uninsured 39%

9 THE COMMONWEALTH FUND 9 One-Third of College Graduates Had Time Uninsured in Year Following Graduation, 2001–2003* *People who graduated from college during 2001–2003. Note: College graduates are defined as those with at least a bachelor degree. Source: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May Analysis of the 2001 Panel of the Survey of Income and Program Participation by E. Gould for The Commonwealth Fund. Percent of college graduates

10 THE COMMONWEALTH FUND 10 Lacking Health Insurance Threatens Young Adults’ Access to Care, 2007 Percent of adults ages 19–29 reporting the following problems in the past year because of cost: Source: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May The Commonwealth Fund Biennial Health Insurance Survey, 2007.

11 THE COMMONWEALTH FUND 11 Young Adults Without Insurance Are Less Likely to Have a Regular Doctor, 2007 Percent of adults ages 19–29 who have a regular doctor Source: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May The Commonwealth Fund Biennial Health Insurance Survey, 2007.

12 THE COMMONWEALTH FUND 12 Young Adults with Any Time Uninsured Have High Rates of Medical Bill Problems, 2007 Percent of adults ages 19–29 who had the following problems in past year: *Includes only those whose bill was sent to a collection agency when they were unable to pay the bill. Source: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May The Commonwealth Fund Biennial Health Insurance Survey, 2007.

13 THE COMMONWEALTH FUND 13 Annual Per Capita Total Health Expenditures by Age Group, 2008* Dollars *Inflated to 2008 dollars using actual and estimated annual growth rates in national health expenditures. Source: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May Analysis of the 2005 Medical Expenditure Panel Survey by S. Glied and B. Mahato for The Commonwealth Fund.

14 How New Policies Can Help Extend eligibility for Medicaid/SCHIP public coverage beyond age 18 Extend eligibility for dependents under private coverage beyond age 18 or 19 –24 states have enacted legislation requiring insurers to provide health insurance coverage to dependent young adults on their parents’ health plans beyond age 18 or 19, (up to ages 24–30) –23 of these states have passed laws since 2003, reflecting states’ rising concern about the steady loss of coverage among young adults –Increasing the age to 23 could cover an estimated 1.4 million unmarried, dependent young adults –Increasing the age to 25 could cover 1.9 million unmarried, dependent young adults –Policies could be structured as riders or extended to all policies and covered by family premium States could ensure that all colleges and universities require full-time and part-time students to have health insurance, and offer health insurance coverage to both Source: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May 2008.

15 THE COMMONWEALTH FUND 15 J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May