Health and Healthcare

Massive Numbers Aged 20 to 35 Still Go Without Health Insurance

The latest data from the U.S. Census Bureau on poverty, health insurance and income for 2014 shows that the rates of those going without health insurance is coming down in every age group. That being said, there is a very different story around which age groups are choosing to go without having any coverage.

If you look at the graph provided by the Census on the rate of uninsured (see below), it does show that there has been a drop in the rate of uninsured in all age groups. It also shows an alarming number of people aged 20 to 35 (millennials) are still going without health insurance.

As of 2014, there are still one in four (25%) of those people aged 25 who are going without health insurance. If you take an average of the people aged 20 to 35, there are still roughly one in five (20%) not covered by health insurance.

There are myriad reasons why those aged 20 to 35 are going without insurance. An admission also has to be made up front that someone’s belief or reasoning for this actually may depend on which side of the political aisle they are on. After all, Republicans call the new health care regime “Obamacare” and Democrats call it “Affordable Care.” That being said, 24/7 Wall St. has perhaps a financial evaluation of this that is hopefully not interpreted politically.

There are many issues covering those aged 20 to 34, a huge portion of millennials. There is the cost of health care. Some states have different insurance laws and policies under their health insurance exchanges. Many young adults on both sides of the political aisle think their health care is too expensive. If you are in your 20s or early 30s, there is still the “invincibility” belief that can play a role. Many young adults feel they are subsidizing too many others to have insurance. And many young adults have figured out that it is quite simply cheaper to pay a tax penalty (fee) in their taxes than it is to buy insurance. And another issue is that insurance is now available on almost no notice and without the “pre-existing condition” exclusions from years past.

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The HealthCare.gov website outlines the penalties for not having health coverage. This has been broken out for the years 2014, for which the Census data would cover, and for 2015 to see what the difference may be when Census issues this same data next year. These are as follows, and are taken directly from the HealthCare.gov data:

  • The fee for not having coverage in 2014 was the higher of these two amounts: “1% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,150 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a Bronze plan. … Or … $95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.”
  • The fee for not having coverage in 2015 is the higher of these two amounts: “2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,150 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a Bronze plan. … Or … $325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is $975.”

A real consideration ahead is what the penalty rises to in 2016 and beyond. The HealthCare.gov site shows that if you don’t have coverage in 2016, you will pay the higher of these two amounts: 2.5% of your yearly household income, or $695 per person ($347.50 per child under 18). In future years, the fee is adjusted for inflation.

ALSO READ: How Obamacare Increased Insurance Coverage in Every State

Another issue to consider is that those aged 20 to 35 are not married, and fewer of them are parents or have dependents than higher ages. The Census has broken out the “real median household income” by race, origin and as a total as follows for the year 2014:

  • Asian, $74,300
  • Non-Hispanic white, $60,300
  • Hispanic (any race), $42,500
  • Black, $35,400
  • All households (50th percentile), $53,700

The poverty rate was shown to be 14.8%, with some 46.7 million people living in poverty. In 2014, those broken down in the ages 25 to 34 had 18.2% of females and 11.3% of males living in poverty.

Additional apolitical explanations beyond what has been said above for being uninsured would be that those in their 20s and 30s likely have higher student loan burdens. Many in their 20s still live at home. Many are still in college. Those in their 20s and early 30s also have not had any major illnesses.

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The national average provided for health care costs from the National Conference of State Legislatures was updated in July of 2015. It showed that annual premiums edged beyond $16,800 for an average family. On an individual rate, the national average’s monthly rate for a 40-year old non-smoker in 2015 was $256 for a bronze plan and $314 for a silver plan. That figure fluctuates handily from state to state, and the Kaiser Family Foundation showed that the 2013 average rate in New York for all ages (community-rated state) was $428.54 per month.

So what happens when people are strapped and they have to make a hard decision on paying a small penalty with their taxes or pay $250 to $400 per month for their insurance? This is a very complicated matter, and there is not just one answer here. If you believe in game theory, the logic behind why anyone would go without insurance by choice may simply boil down to the raw dollars involved. For those who do not get a subsidy, or who do not have a company-sponsored (or paid-for) plan, it may just be cheaper to go without insurance.

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