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Nearly one in three young adults ages 19 to 26 lacks health insurance coverage. This age group is at high risk of lacking insurance coverage because of low access to employer-sponsored insurance and subsidized public coverage. Given that so many uninsured young adults are low-income, significant public subsidies will be needed to address their uninsurance problem. Some policy options available include public program expansions, tax credits, direct subsidies, or individual mandates. Ultimately, decisions about allocating greater public subsidies for covering young adults or imposing mandates should be made in the context of considerations about broader health care reform.
Given that such a large and growing
share of young adults ages 19 to 26
lacks health insurance coverage,
increasing policy attention has been
focused on addressing coverage gaps
among young adults. Fully 10.3
million young adults—or one in three
(32 percent)—lack health insurance
coverage. While young adults constitute
18 percent of the adult population, they
make up 28 percent of the uninsured
adult population (Exhibit 1). Almost half
(49 percent) have employer-sponsored
insurance (ESI) coverage, 10 percent
have Medicaid/other public coverage,
and 10 percent have non-group
coverage (Exhibit 2).
As shown in Exhibit 3, as children
transition to adulthood, they lose both
employer-sponsored insurance (ESI)
and Medicaid coverage at high rates.
The sharp declines in ESI and Medicaid
coverage are due to restrictions on
employer policies that often limit
dependent coverage to full-time
students after age 18 or 19 and less
expansive Medicaid/SCHIP eligibility
policies for young adults compared to
those for children ages 18 and under.
As young adults move into their late 20s,
they gain ESI coverage, which brings
down their uninsured rates.
Among young adults, the likelihood
of coverage varies across a number
of different characteristics, including
income, citizenship status, and whether
or not they are full-time students.
Young adults with incomes less than
200 percent of the federal poverty
level (FPL) are 2.6 times more likely
to be uninsured compared with
those with higher incomes (44 vs.
17 percent) (Exhibit 2). While lowerincome
young adults are more likely
to have Medicaid/SCHIP coverage
relative to higher-income young adults
(16 vs. 3 percent), they are much less
likely to have ESI (29 vs. 73 percent).
Young adults who are noncitizens
are over twice as likely as those who
are citizens to lack health insurance
coverage (60 vs. 28 percent) but make
up just 22 percent of all uninsured
young adults (Exhibit 1).
Full-time students are half as likely as
nonstudents to lack health insurance
coverage (19 vs. 39 percent), and it
appears that 1.9 million, or fewer than
one in five, uninsured young adults are
students (data not shown). Consistent
with the patterns found among all
adults, uninsured rates are higher
among young adults who are Hispanic,
noncitizens, and among those who are
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