Health Insurance Coverage of Young Adults

Issues and Broader Considerations

Nearly one in three young adults ages 19-26 lacks health insurance, accounting for 28 percent of America's uninsured population. This Urban Institute analysis looks at why young adults are disproportionately uninsured and what policies could address their coverage gaps.

While conventional wisdom suggests that these largely healthy young adults reject coverage because of their youth and vitality, the facts tell a more complicated tale. As children transition to adulthood, they often lose the security of their parents' employer-sponsored insurance (ESI) or coverage through Medicaid and the State Children's Health Insurance Program. Large numbers of young adults do not work full time and are not full-time students, leaving them without their own ESI—or their parents'—and without the income to afford private market coverage.

This lack of coverage significantly lowers the likelihood that young adults will receive needed care when they are sick. Compared with their insured peers, they are more than twice as likely not to fill a needed prescription due to cost; not to see a specialist when needed; not to get a medical test, treatment or follow-up; and not to see a provider when they have a medical problem.

The authors examine the root causes of unisurance among young adults and assess the potential effects of such policy options as tax credits, Medicaid expansions and individual mandates.