The Myth of the Young Invincible

At the heart of the current health care debate, there’s a yawning generation gap. This summer, it was senior citizens who grabbed headlines as anti-reform activists drummed up fear about government “death panels” and Medicare cuts. By contrast, young people have largely stayed away from the large-scale rallies and grassroots organizing on either side of the debate. Just last week, President Barack Obama reached out to his youth base at a rally at the University of Maryland–College Park, arguing that their stake in health care reform debate is significant. Obama told the 15,000-person crowd that over a third of Americans under 30 years old lack health insurance. “Nearly half of these young people have trouble paying their medical bills. Nearly 40 percent are in debt because of it,” he said.

Certainly young people, like other segments of the population, stand to benefit significantly from cheaper, more accessible health insurance—the primary goal of progressive health care reform proposals. Right now, only 53 percent of working young adults is eligible for employer-based coverage, according to a 2008 study by the Commonwealth Fund, a private foundation that advocates in favor of health care reform. Young adults are far more likely to be working part-time or lower-paying jobs for employers who don’t offer coverage. They also change jobs far more often than their older counterparts, risking even less security that they’ll be covered. Through reforms like a health insurance exchange, subsidies to help low-income people buy insurance, and new rules that would allow them to access their parents’ insurance, more young people could have access to comprehensive care—and be able to afford it.

But everywhere you turn, media reports and politicians call these young people the “young invincibles”—those who opt out of buying insurance because they think they’re invulnerable and will live forever. “They’ve got a life ahead of them that seems 1,000 years long. ... They don’t believe they’re going to die. They don’t think they’re going to get sick,” Marge Ginsburg, executive director of the Center for Healthcare Decisions, told Politico.

However, there’s strong evidence to suggest that this just isn’t the case for many, if not most, young uninsureds. In its 2008 study, the Commonwealth Fund found that 66 percent of young adults aged 19 to 29 who experienced a time without coverage in the past year said they had gone without it because of the cost. Back in February, The New York Times shed more light on some of these young not-so-invincibles, who “borrow leftover prescription drugs from friends, attempt to self-diagnose ailments online, stretch their diabetes, and asthma medicines for as long as possible and set their own broken bones.” And, while rates of chronic disease tend to be lower in this age group than in other segments of the population, there are still young people that live with frequent doctor visits and medication regimens.

The problem is that the myth of the “young invincibles” is still dominating the reform debate, which may end up weakening coverage reforms offer to young people. Last week, when Senate Finance Committee Chairman Max Baucus unveiled his reform plan, he described a new provision that would encourage insurance companies to offer a catastrophic plan to those under 25 years old, a plan that offers a high deductable with some preventative care coverage. Such an option would be better than nothing, but Baucus’ proposal is no substitute for reform that would offer comprehensive care to the young people who need and want to have such choices. Young people might have a better chance of accessing comprehensive coverage if there were a public plan, which could lower the cost of insurance, particularly for those without good employer benefits. Young people may also have a better chance at coverage if there were generous subsidies for lower-income individuals, as many take lower-paying jobs when they first enter the workforce. But the Baucus plan—which is setting the agenda for the bill in the Senate—contains no public plan and threatens to scale back such subsidies.

Baucus and others might argue that they’re just trying to make reform more palatable to young people who might resent having to purchase insurance under the individual mandate, a requirement that would fine individuals who do not purchase insurance, which Obama insists upon. To be sure, this concept may take some getting used to, particularly for young people not accustomed to factoring health insurance into their budgets. But that’s why it’s all the more important to have provisions in the bill that ensure affordable health insurance options for young people who want comprehensive care. In fact, the very idea that young people would be virulently opposed to a mandate is another myth—polls show that 52 percent in favor it, just as high a margin as other age groups. What’s more, those under 30 are the group most in favor of Obama’s comprehensive reform plan, with 60 percent in support. Compare that with the 42 percent of the general population that favors Obama’s reform plan.

Unfortunately, these aren’t the voices that are currently at the forefront of the health care debate. Instead we get laments that young people simply don’t want health insurance. This makes it all too easy to conclude (falsely) that young people simply don’t care that much about health care reform. In truth, young adults could be some of the best advocates for a robust, comprehensive reform package—affirming that they want real coverage, and that they are willing to do their part to shoulder the cost to ensure that America’s health care system remains viable over the course of their own lifetimes. In the absence of such demands, legislators—including Obama himself—will continue to assume that young people are uninsured because they’re simply “irresponsible.” If young people want to have the health care coverage they’re looking for, they’re going to have to be more vocal about demanding it.

Suzy Khimm is a reporter-researcher at The New Republic. Follow her on Twitter.

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