The success of the Patient Protection and Affordable Care Act hinges in great part on the so-called “young invincibles.”
That’s the term Atlanta attorney Richard Sanders used for young, healthy adults between ages 18 and 28 at a recent seminar in Gainesville on the new health care law and the insurance exchanges.
Also known as Obamacare, the law was passed in 2010 so more uninsured people could get affordable health insurance. It uses a public-private model that allows people to go online “marketplaces” to sign up for coverage.
The controversial law prohibits insurance companies from denying coverage for pre-existing conditions, keeps young adults under 26 years old on their parents’ insurance and helps low-income people get affordable coverage by offering subsidies or helping states expand their Medicaid population.
Georgia’s three-year average of uninsured residents has hit 19.7 percent, the fifth-highest rate in the country, according to recent statistics from the U.S. Census Bureau.
The health care law mandates that individuals must have insurance next year or pay a tax. That means Hall County resident Joseph Wilson must buy health coverage
It’s important that young adults such as Wilson buy insurance because insurance companies can no longer deny people with pre-existing conditions. The pool of applicants is older and sicker, so to keep rates low for everyone, the risk needs to be spread out among as many people as possible who have fewer health problems.
Wilson, 27, is single and healthy, but hasn’t had health insurance for about a year. He works for a small business, one with about 30 employees, doing lawn care and landscaping. The company tried to offer health insurance, but most of the workers couldn’t afford the coverage, Wilson said.
The employer mandate, which requires businesses with 50 or more employees to cover full-time workers, has been postponed until 2015.
He had an individual policy for about a year and a half until the rates increased. He went for two years without insurance, describing them as his “invincible years.”
“I wasn’t going to get hurt or sick,” he said.
Wilson isn’t feeling so invincible these days. He’s trying to save money to buy a house for the family he wants to have. On the other hand, he’s hasn’t visited the emergency room and his only health complaint is an allergic reaction to nickel.
“I wouldn’t say I’m invincible,” Wilson said. “I think I’m less likely to have a problem, but I wouldn’t say I’m invincible. Maybe four years ago, yes.”
He said his family and friends pressure him about being uninsured. He is opposed to the law because he believes in smaller government and that the private sector could do a better job.
The penalty for not buying health insurance in 2014 is $95 or 1 percent of household income. It rises to $325, or 2 percent of income, in 2015 and $695 or 2.5 percent in 2016.
“I would rather pay for insurance than pay a penalty,” Wilson said.
Wilson said he he’s read about the new law and the exchanges, but isn’t up to speed with the latest developments. He feels he’s going to have to give up some of the fun in his life to pay for coverage and wouldn’t want to spend more than $150 a month for insurance. He said he makes an estimated $40,000 a year.
“I would have to stop saving,” Wilson said. “(Health insurance) is a priority, but it’s tough to fit into the budget.”