Many still unaware about upcoming Affordable Care Act

theGRIO REPORT - LaTobia Avent, a 25-year old resident of Greensboro, North Carolina, is all too familiar with the struggle of not having health insurance...

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LaTobia Avent is a healthy, young African-American female who has a bright future ahead of her. She is a graduate of North Carolina A&T and has finally landed a full-time job after a long search post-graduation. Avent, a 25-year old resident of Greensboro, North Carolina, is all too familiar with the struggle of not having health insurance. She was dropped from her stepfather’s insurance after her parents divorced during her junior year of college and only recently became insured again.

“Luckily, I only needed check ups in college but I got bronchitis one time and went to urgent care,” she said. “They charged me about $100 for a check up and my prescription. I didn’t have that kind of money as a full time student.”

Avent was unaware of the Affordable Care Act and how it was crafted, in part, to help others in similar situations — that is, until her interview with theGrio.

A new survey shows that Avent is one of millions of African-American youth between ages 19 and 29 that want health insurance, but are deterred by the cost and are unaware that the marketplace that will launch in October will present affordable health insurance options for them.  Moreover, if some states choose not to expand Medicaid, millions of low-income young adults run the risk of remaining uninsured and paying a penalty.

Affordability trumps invincibility

The Commonwealth Fund did a survey of more than 3,000 young adults ages 19 to 29 in 2011 and 2013 about health insurance and their knowledge of the Affordable Care Act provisions. In spite of stereotypes about youth feeling like they don’t need health insurance, the survey found that the majority of young adults do indeed want health insurance.  The report cites that when offered health insurance through an employer, 67 percent took the coverage. For those who declined, the primary reason was that they were already covered under a parent, spouse or partner.  A small percentage of those surveyed (22 percent) stated that they couldn’t afford the premiums and only 5 percent said they didn’t need it.

Among African-American young adults, 43 percent of the total surveyed in 2013 did not know that they could remain on their parents’ health plans until the age of 26 and only 32 percent actually remained on their parents’ plan.

With the unemployment rate among African-American youth lingering at 20.9 percent, it is likely that lack of employment plays a large factor in the reason why African-American young adults are not insured.

The need for awareness

Jonathan Hall is a 22-year-old African-American middle school English teacher in Washington, DC.  In an interview with theGrio, the Savannah State University grad says he was excited about the Affordable Care Act when he heard about the benefits.  Jonathan had a short lapse without insurance before gaining full time employment and it worried him.

“You don’t realize how things affect you until it’s right there in your face. I never had to really deal with it until I was in between college and employment and then it was like ‘Oh my God’ I have no insurance. If something were to happen you realize that there will be medical bills and you could be in debt.  It’s not the safest thing,” he said.

Hall is among the minority of young adults that know the importance of obtaining health coverage before March 2014. The report showed that many young adults are still unfamiliar with the many details of the Affordable Care Act that can benefit them.

Results from the survey showed that only 27 percent of the participants knew of the marketplace launch on October 1. And more specifically, among African-American youth, 78 percent had not heard about the new health insurance exchange for people without coverage.

The Medicaid Factor

Another critical factor in health policy reform is Medicaid. Millions of young adults in poverty may miss the opportunity to enroll in Medicaid because their state is not opting to expand Medicaid programs to 133 percent of the federal poverty level.  Some 25 states may not participate in the Medicaid expansion despite the expansion being fully funded by the federal government.

If states choose not to expand, adults with incomes between 100 percent and 133 percent below poverty level will qualify for subsidized private health insurance through the new marketplace. However, most working adults with incomes below 100 percent of poverty will not qualify for Medicaid expansion or subsidized private plans, leaving them in health insurance limbo. Fortunately, according to the report, 82 percent of the 15 million young adults who were uninsured for a period during 2013 were in households that were eligible for subsidized private plans or Medicaid.

In the upcoming weeks, outreach to young people about the marketplace will be critical.  Their enrollment in health insurance provides a back up for worse case scenarios of life, saves them from thousands of dollars of medical debt, and protects them from paying penalties at tax time. On a larger scale, young adult premium payments keeps the overall costs of healthcare down as older, sicker participants continue to use benefits.

Awareness and support are pivotal points to address.

Candace Y.A. Montague is a health advocate and freelance writer in Washington, D.C.  She is the DC HIV/AIDS Examiner for  Candace is also the health reporter for East of the River Magazine, a publication of Capital Community News. She is a contributor to The and The Black AIDS Weekly.  Writing is her activism.