At Risk: Young Adults Without Health Insurance

At Risk: Young Adults Without Health Insurance

Tchernavia Montgomery, executive director of Charlotte-based Care Ring, said North Carolina lawmakers’ reluctance to expand Medicaid eligibility, combined with lack of access to private health insurance in the federal market, makes harder for young adults to get coverage.

When Tash Qawwee left her mother’s health insurance at the age of 22, she began to worry about the consequences of a serious illness on her financial health.

“I try to do my best to stay out of harm’s way and if something happens I try to deal with it to the best of my ability and knowledge,” said Qawwee, 25.

Although Qawwee is enrolled in a family Medicaid plan, the only thing she may be covered for are exams. As an independent contractor who does not qualify for a business plan, his health care must be paid for out of pocket, and obtaining private insurance brings an additional financial burden.

“I don’t have private insurance because I don’t have a full-time job to be able to pay for insurance or have it covered for me,” she said. “The anxiety of being in a situation that would require medical attention is the scariest part.”

Like Qawwee, most people without adequate health insurance in Mecklenburg County are young. About 50% of young adults in the county between the ages of 18 and 29 do not have health coverage according to a survey conducted by the health department.

“Access to primary care continues to be one of the top health concerns for Mecklenburg County residents,” said Dr. Raynard Washington, Mecklenburg County Public Health Director. “This report provides an overview of the current landscape, offers recommendations for all community stakeholders and, of course, the data to inform future decisions and progress.”

This population remains the highest rate of uninsured of any age group according to the Centers for Medicare and Medicaid Services.

In the 2019 American Community Survey, adults between the ages of 19 and 34 accounted for 30% of uninsured Americans. About 11% of Mecklenburg County residents do not have coverage, 23% of residents reported not having a primary care provider, according to the 2021 Mecklenburg County Behavioral Risk Factor Surveillance System survey.

When people are left without health care, acute conditions that could be managed with regular screening can become more serious, leading to complex care and more money spent at the doctor’s office.

“We haven’t expanded Medicaid in our state, so it may be harder for them to get public coverage,” said Tchernavia Montgomery, executive director of the nonprofit Care Ring in Charlotte. “They would need to switch to a private plan. It is sometimes difficult to make this transition or to be able to absorb this cost.

Many find themselves without health coverage once they are kicked out of their parents’ health insurance after the age of 26, when under the Affordable Care Act they are no longer considered persons. dependent. Once they reach age 27, they are on their own for federal market insurance unless they get a job with health benefits.

“That means you can go to college and the working world and have insurance while you’re looking for work or in between jobs,” Montgomery said.

Prior to the ACA, many health plans and insurers removed young people from their parents’ policies because of their age, leaving many college graduates without coverage.

Young people have less access to employer-based insurance, they typically start with entry-level, part-time jobs, or for small businesses that don’t offer health coverage.

The chances of getting private insurance during the interval are a possibility, but for people between jobs, it’s a luxury many can’t afford or even think about.

“I’ve been without coverage for so long that I haven’t even thought of getting private insurance,” said JarQuez Anderson, 25, who has been without health insurance since October 2020. “My biggest fear is getting hurt. and not being able to work and support my family.

When Anderson aged out of his parents’ health care, he began looking for a job that could take care of these issues, but was unsuccessful. Like many, Anderson believes health insurance should be provided by employers.

“I feel like it’s [not offered] because they are cheap,” he said. “The state needs to be more interested in companies that don’t provide benefits, because if you’re working, I feel like the company should still be providing that.”

A common belief among many young people is that they are perfectly healthy and can live without health insurance. According to CMS, one in six young adults suffer from chronic diseases such as cancer, asthma or diabetes. The high cost of care is making it harder for them to afford coverage, with nearly half of uninsured young Americans saying they have trouble paying their medical bills.

North Carolina has not expanded Medicaid coverage, but if the state expanded Medicaid, it would cover an additional 64,281 Mecklenburg County residents and 600,000 people statewide. As of October, more than 2 million North Carolinas were covered by the public insurance program. In 2022, the federal government offered the state $5.9 billion for Medicaid expansion, but the Republican-leaning General Assembly said no.

Lawmakers were unable to reach a mutual agreement on logistics and are expected to revisit the matter in 2023.

Aaliyah Bowden, a member of the Report For America body, covers health for The Post. Mayra Parrilla Guerrero is a correspondent.

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