If the Price is Right, Most Uninsured--Even Young Invincibles--Likely to Consider New Health Insurance Marketplaces

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Most uninsured young adults, or "invincibles," believe that they need health insurance.

Starting January 1, 2014, new federal subsidies will be available for lower- to middle-income people to purchase private, nongroup coverage through new health insurance exchanges. A key issue for the exchanges is whether enough younger and healthier people will sign up for coverage to avoid significant adverse selection in which only older and sicker uninsured adults enroll, thus driving up premiums.

This brief, conducted by RWJF grantee Center for Studying Health System Change (HSC) examines which uninsured adults ages 18 to 64 are most likely to purchase insurance through the exchanges. 

Key Findings

  • Just two in 10 (22.1%) of uninsured adults ages 18 to 64 believe they are "healthy enough" to go without health insurance.

  • About one-third of uninsured nonelderly adults describe themselves as risk-takers. They are more than twice as likely to believe they do not need health insurance (33.2%) or that it is not worth the cost (51%) compared to uninsured people who are risk-averse.

  • Beliefs about the need for insurance vary dramatically across the states. Twenty-seven percent of uninsured adults in North Carolina, for example, don't believe they need health insurance compared to just 11 percent in South Carolina.

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