Young Adults Need Coverage, and Texas Can See That They Get It

This commentary by Texans Care for Children staff appeared in the Austin American-Statesman on February 2, 2014.

As the deadline to enroll in the new Health Insurance Marketplace gets closer, many are asking whether the youngest consumers will opt for coverage. People between the ages of 18 and 26 are some of the most likely to go uninsured. They also are the group most likely to suffer an injury or death at the wheel and are likely to experience mental health concerns, addiction, violence and STDs.

In other words, young people need to see a doctor as much as any of us do. What stands in their way, especially in Texas, is opportunity.

A recent survey of the uninsured commissioned by Enroll America found two-thirds of young adults don’t know about new financial help that’s available to help them pay for insurance in the marketplace. Yet more than half of people in this age group can get covered for less than $50 a month. Ensuring more young people have coverage is good for public health, so our state agencies should be out spreading the word about the new options. Instead, Texas rejected resources for the outreach to make that happen.

Our state is putting up even bigger barriers to getting covered for some other young Texans.

Lisa, 20, spent her teen years in foster care. She was a standout kid in an Austin-area youth program and graduated from high school the same year she graduated from foster care. At 18 without any family support, she managed to get her own apartment. But within a year, Lisa found herself pregnant and homeless.

Neither situation is unusual among people who have been through what Lisa has. Getting removed from a neglectful or abusive home, only to be put into a series of foster homes without ever having an adoptive family, can lead to terrible odds. More than 1 out of every 3 homeless adults is a former foster kid. And youth who age out of foster care are far more likely to have trouble holding a job, staying in school and escaping poverty.

To its credit, Texas has done a lot over the years to extend educational and social supports to youth who age out of foster care — even young adults who were formerly in the custody of another state. But right now, our state seems to be drawing the line at health care for some at-risk youth. Our state Health and Human Services Commission has adopted rules that scale back health insurance in the Former Foster Care Children’s Program. As enacted, former foster kids younger than 26 who spent their last months in foster care out of state won’t be able to get health coverage moving forward —even if they spent most of their lives in Texas.

Covering this group in the past has cost Texas hardly anything, prompting advocates to wonder what changed. The answer is politicians, apparently eager to brandish their opposition to the Affordable Care Act, now want to opt against this coverage because they perceive it as linked to the nation’s health law. (The law creates several avenues to coverage for younger adults, including former foster youth.) In a rush to reject all things Obamacare, Texas officials are proposing to throw under the bus some youth our state once promised to help. Such a proposal is unconscionable.

Similar posturing is keeping another Texan, Monica, 22, from health care she needs. Monica and her teenage brother both cope with serious attention deficit disorders. Still, both excelled in high school and extracurricular activities thanks to effective treatment made possible by Children’s Medicaid. When Monica went to college, she still had public health insurance and her focus remained, but turning 19 meant an abrupt loss of Medicaid — along with the treatment that helped her succeed. Monica wound up struggling and eventually dropping out. She now fears her brother could face a similar fate.

Many people with mental health problems develop them during adolescence or early adulthood. Research shows having health insurance has a pronounced positive effect on mental health. Yet once again, top officials’ zest to reject the Affordable Care Act led to no expansion of Medicaid for young adults like Monica — even though the state had a chance to insure them at no cost to Texas. A million Texans now earn too little for the Health Insurance Marketplace and too much for Medicaid, due to a state-inflicted coverage gap.

Helping insure young Texans is the compassionate thing to do and pays dividends for society as a whole. For these young Texans, our state should promote coverage today that leads to independence and success for years to come.

Written by Ashley Harris, Texans Care for Children. Cross-posted from the Texans Care for Children Newsroom.