Young adults have always been uninsured at rates far exceeding the national average. But contrary to what some may suggest, that’s not because young people don’t want or think they need health insurance; it’s that too many financial barriers have stood in the way of young people being able to afford coverage. The ACA helped millions of young people gain health insurance, cutting the group’s uninsured rate in half. Unfortunately, some young adults continue to struggle to afford coverage.
The good news is that last week Senator Tammy Baldwin (D-WI) introduced a new bill in the U.S. Senate called the Advancing Youth Enrollment (AYE) Act that would help more of these young people get covered by enhancing premium tax credits for more than 4 million uninsured young adults. With the typical uninsured young person making just $20,000 a year, this extra financial assistance would help more young people have the financial security they need to purchase a plan and get covered.
How would it work and who would qualify? Medicaid- and CHIP-ineligible young adults (ages 18 to 30) earning between 100 and 400 percent of the Federal Poverty Level (or roughly $12,000 to $49,000 a year) would see the maximum percent of their income they must pay toward insurance premiums go down by 2.5 percent. This would reduce monthly premiums for young people by roughly $50 a month. This would help nearly 300,000 young adults get a health plan with no deductible for free and another 200,000 get a plan with no deductible for $23 a month or less. Qualifying individuals between the ages of 31 and 34 would also be eligible for increased financial assistance, just to a slightly smaller degree. In fact, under the proposal, roughly 104,000 32 to 34 year-olds would be eligible for no deductible plans for $15 to $52 a month.*
Take 31 year-old small business owner Sadie from Wauwatosa, Wisconsin. She makes $35,000 a year and currently pays $270 a month for a silver plan. Under AYE, Sadie would see her premium tax credit go up $58 a month, bringing the cost of her silver plan down to $212 a month. Sadie told us that that extra $700 a year will help her business. She will be able to continue employing the part-time help she hired last fall — currently she has to monitor staff hours very closely and scale them back if business is slow. More young people with coverage, jobs, and greater financial security? Count us in!
Young people in the states (like Sadie’s Wisconsin) that have refused to expand Medicaid under the ACA could actually see some of the greatest gains under the AYE Act. While these states are unquestionably ill-serving their constituents, young people are experiencing medical and financial emergencies for which they need the benefits of health coverage. Under AYE, young people from the 19 non-expansion states represent 56 percent of the uninsured young adults who would be eligible for enhanced premium tax credits.** All members of Congress, but particularly those from these states, should follow Senator Baldwin’s lead to expand access to coverage. These low-income youth can’t — and shouldn’t have to — wait for the next election cycle to pass to see if their state leaders will embrace Medicaid expansion and actually help them get health coverage.
Check out how many uninsured young people in your state could benefit from the Advancing Youth Enrollment Act, and then write your Senator and ask them to cosponsor this important piece of legislation, because it’s time to build on the successes of the ACA, not unwind them.
State |
Number of uninsured marketplace-eligible young adults (19-34) |
Number of uninsured marketplace-eligible young adults (19-34) who could receive enhanced tax credits under AYE |
Percent of uninsured marketplace-eligible young adults (19-34) who are eligible for subsidies |
Alabama |
113,000 |
72,000 |
63.72% |
Alaska |
34,000 |
18,000 |
52.94% |
Arizona |
189,000 |
99,000 |
52.38% |
Arkansas |
63,000 |
33,000 |
52.38% |
California |
723,000 |
316,000 |
43.71% |
Colorado |
167,000 |
78,000 |
46.71% |
Connecticut |
45,000 |
29,000 |
64.44% |
Delaware |
23,000 |
12,000 |
52.17% |
District of Columbia |
9,000 |
3,000 |
33.33% |
Florida |
681,000 |
355,000 |
52.13% |
Georgia |
381,000 |
185,000 |
48.56% |
Hawai’i |
21,000 |
6,000 |
28.57% |
Idaho |
29,000 |
23,000 |
79.31% |
Illinois |
275,000 |
131,000 |
47.64% |
Indiana |
150,000 |
63,000 |
42.00% |
Iowa |
57,000 |
35,000 |
61.40% |
Kansas |
87,000 |
58,000 |
66.67% |
Kentucky |
66,000 |
37,000 |
56.06% |
Louisiana |
148,000 |
65,000 |
43.92% |
Maine*** |
19,000 |
11,000 |
57.89% |
Maryland |
95,000 |
50,000 |
52.63% |
Massachusetts |
79,000 |
36,000 |
45.57% |
Michigan |
196,000 |
113,000 |
57.65% |
Minnesota |
47,000 |
16,000 |
34.04% |
Mississippi |
124,000 |
69,000 |
55.65% |
Missouri |
152,000 |
92,000 |
60.53% |
Montana |
25,000 |
10,000 |
40.00% |
Nebraska |
30,000 |
19,000 |
63.33% |
Nevada |
75,000 |
42,000 |
56.00% |
New Hampshire |
26,000 |
10,000 |
38.46% |
New Jersey |
154,000 |
81,000 |
52.60% |
New Mexico |
61,000 |
26,000 |
42.62% |
New York |
320,000 |
132,000 |
41.25% |
North Carolina |
338,000 |
184,000 |
54.44% |
North Dakota |
18,000 |
7,000 |
38.89% |
Ohio |
207,000 |
103,000 |
49.76% |
Oklahoma |
114,000 |
72,000 |
63.16% |
Oregon |
50,000 |
33,000 |
66.00% |
Pennsylvania |
207,000 |
130,000 |
62.80% |
Rhode Island |
14,000 |
6,000 |
42.86% |
South Carolina |
145,000 |
88,000 |
60.69% |
South Dakota |
23,000 |
11,000 |
47.83% |
Tennessee |
230,000 |
117,000 |
50.87% |
Texas |
1,132,000 |
673,000 |
59.45% |
Utah |
104,000 |
68,000 |
65.38% |
Vermont |
10,000 |
4,000 |
40.00% |
Virginia |
201,000 |
83,000 |
41.29% |
Washington |
140,000 |
73,000 |
52.14% |
West Virginia |
43,000 |
15,000 |
34.88% |
Wisconsin |
126,000 |
81,000 |
64.29% |
Wyoming |
16,000 |
10,000 |
62.50% |
TOTAL FOR ALL STATES |
7,782,000 |
4,083,000 |
52.47% |
TOTAL FOR NON-EXPANSION STATES |
4,045,000 |
2,271,000 |
56.14% |
Source: Young Invincibles’ analysis of US Census 2017 Current Population Survey data.
* Young Invincibles analysis of US Census 2017 Current Population Survey data for marketplace-eligible uninsured young adults eligible for tax credits earning between 100 and 150 FPL. Premium calculations computed using Kaiser Subsidy Calculator. Deductible values come from Kaiser Family Foundation Impact of Cost Sharing Reductions on Deductibles and Out-Of-Pocket Limits report.
** 2.271 million of the 4.083 million uninsured marketplace-eligible young adults (or 55.6 percent) live in non-expansion states and could qualify for enhanced subsidies under AYE.
*** Maine voted via ballot referendum to expand Medicaid in November 2017, however given that Governor LePage’s refusal to implement the expansion, Young Invincibles has included Maine among the list of states that have not expanded Medicaid under the ACA.