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Finding health insurance options after the Affordable Care Act

Chicago Tribune

By: Carolyn Bigda

Open enrollment for the new health care marketplace is well underway, and 20- and 30-somethings are signing up for coverage. According to the Department of Health and Human Services, more than half a million 18- to 34-year-olds had selected plans through the end of December.

But there’s plenty more to go. Young adults have the highest rate of uninsurance in the U.S. — an estimated 19 million lack coverage, according to some estimates — and while you have until March 31 to sign up for care through state and federal online exchanges, you don’t want to wait too long.

The Affordable Care Act, the fee for missing the deadline and going without insurance this year is either $95 or 1 percent of your income, whichever is greater.

How can you find affordable insurance? Here are ways to save.

Stay on your parents’ insurance. This option is available if you’re age 25 and under. You qualify even if you are financially independent, married and no longer live at home. So far, about 3 million young adults have received coverage through this provision of the health care law, according to Jen Mishory, deputy director at Young Invincibles, a national advocacy group for young adults.

Get a subsidy. If you can’t stay on a parent’s policy or it’s not a good option (say, because you live across the country, outside the plan’s network of doctors and hospitals), you can buy your own insurance through the health care marketplace.

For many young adults, subsidies are available to help cover the cost. To qualify, you can’t have access to employer-provided insurance and your earnings must fall within 100 percent to 400 percent of the federal poverty level. For a single person, that translates to $11,490 to $45,960 in annual income.

“A lot of young adults are going to qualify,” Mishory said, who notes that many entry-level and low-wage positions — the type offered to young people starting out — lack benefits.

To get an estimate of your subsidy, use the Kaiser Family Foundation’s online calculator at

Apply for Medicaid. If you have very little earnings, you may qualify for Medicaid, a government health program for low-income households.

As of Jan. 1, states can expand Medicaid to include individuals who earn less than 138 percent of the federal poverty level. At this time, 25 states, plus the District of Columbia, are participating. As a result, an additional 2.4 million 19- to 34-year-olds who previously were ineligible for Medicaid now qualify, according to estimates by the Urban Institute, a nonpartisan research group.

“Young adults are a big part of the population affected by the Medicaid expansion,” said Genevieve Kenney, a senior fellow and co-director of the Health Policy Center at the Urban Institute.

To see if you qualify, start an application through your state’s health care exchange.

Request an exemption. What if you live in a state that has not expanded Medicaid yet? You may still be eligible for the government program under existing rules. In fact, the Urban Institute estimates that an additional 3 million young adults qualify for Medicaid but are not enrolled.

One of the biggest gaps in the law is that individuals who earn less than 100 percent of the federal poverty level but don’t qualify for Medicaid are not eligible for subsidies. The law, as originally drafted, assumed all states would have to expand Medicaid. In 2012, the Supreme Court ruled that states had a choice.

If you fall into the gap, consider a so-called catastrophic plan. These policies provide care only in worst-case scenarios (say, in the event of a serious accident), but in turn, carry low monthly premiums.

If a catastrophic plan is still too expensive, you can request a hardship exemption to avoid paying this year’s penalty as you search for more affordable care. To apply, go to