Young Adults and the Affordable Care Act

The health care law promises to extend coverage to millions of young adults, yet many will remain uninsured.

Woman sitting in front of computer holding a phone.

Young adults are a crucial component of the Affordable Care Act. When enrolled in coverage, they provide premium revenue to insurers and generally small payouts for claims.

In order to keep plans viable and affordable for everyone, insurers need healthy, relatively low-cost young adults to enroll.

The Affordable Care Act (ACA) aims to substantially boost the number of Americans with health care coverage in the United States, and young adults are a prominent part of that goal—three out of 10 legal U.S. residents are between 19 and 29 years of age. This age group has historically been uninsured at far higher rates than any other group: 37 percent for 19 to 25 year olds, and 25 percent for 26 to 35 year olds, according to 2008 census data. New provisions in the ACA promise to extend coverage to millions of young adults, although many will likely remain uninsured.

Technical problems initially plagued the federally-facilitated exchange operating in 36 states, as well as some state-run exchanges. If the problems continue into 2014, as well as confusion and uncertainty over whether older plans already in place can continue, then young adults could be dissuaded from signing up in sufficient numbers, something that preliminary evidence seems to suggest happened during the first glitch-prone month.

The Young Invincibles, a nonprofit foundation-supported group, is running numerous campaigns to encourage young people to sign up for health care insurance under the ACA. Even with 100 percent awareness, however, the biggest problem for low-income young adult coverage is the lack of Medicaid expansion in every state. So far, only about half of all states have decided to expand their Medicaid programs under the ACA to add coverage for young individuals, as well as families, and increased eligibility to those earning up to 133 percent of the federal poverty level.


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Of young adults cited cost as their reason for not having health insurance.