Faces of Obamacare: Day 3 "20-somethings" -- Young adults are key to the Affordable Care Act. They tend to be a good risk for insurers because they have fewer medical problems than older people and therefore cost less to cover. However people in their 20s historically have avoided insurance because they think they don’t need it or believe it’s too expensive.
Photo: Richard Watkins/rwatkins@ajc.com
Photo: Richard Watkins/rwatkins@ajc.com

Voices on health care: 20-somethings

About this series: The 20-somethings

Young adults are key to the Affordable Care Act. They tend to be a good risk for insurers because they have fewer medical problems than older people and therefore cost less to cover. Insurance companies now have no choice but to cover anyone who signs up, including people who are chronically ill and, therefore, more expensive to cover. So the law needs those younger people to balance out the sicker folks who will enroll. The problem: People in their 20s historically have avoided insurance because they think they don’t need it or believe it’s too expensive. The Affordable Care Act requires that they obtain insurance, but will they pay the cost or continue to go without?


Robert Kushner

Age: 27

City: Atlanta

Situation: Although he could have afforded insurance, Kushner has gone without it since he went off his mother’s policy several years ago. He acknowledges that this decision has cost him physically. Kushner’s employer offers insurance but he has so far declined to take it.

Impact of ACA:

As of Jan. 1, Kushner will be required by law to have health insurance or face a penalty. The penalty, which will be assessed by the IRS, amounts to just $95 or 1 percent of income, whichever’s higher, the first year. It increases to $695 or 2.5 percent of income in 2016. But Kushner’s employer provides insurance at no cost to him, so he won’t have to worry about penalties.

Kushner’s view:

Four or five years ago I tore my anterior cruciate ligament and meniscus while playing flag football. I stepped in a divot and it popped. I didn’t get it repaired because I didn’t have insurance and couldn’t afford to pay for it out of pocket. Now it limits my physical activity and I’m told I’m pre-arthritic in my right knee. I guess there’s a lot of scar tissue in there.

The cost of health insurance was never an issue for me. It was just the hassle of getting quotes and feeling like I was being swindled. I’d get a quote and the price was good, and then they’d come back and it was a lot higher. It got to the point where I didn’t want to give them my money.

I work as the general manager at the Ivy Buckhead. I’ve been there for two years. The Ivy has always offered insurance for managers. I started (working) at the door, so I didn’t always have it, but I’ve been eligible for insurance since becoming a manager.

Now that I am in a position where health coverage is offered to me, I plan on accepting it graciously, although I have been dragging my feet in submitting the paperwork.

Had I been in the position where I needed to shop for insurance at the exchange, I don’t think I would have been inclined to do so, regardless of the imposed fine.

JaNea Buckingham

Age: 27

City: Decatur

Situation: Buckingham worked for five years as a financial sales rep for MetLife after graduating from Clark Atlanta. The company provided insurance. But she left that job to pursue an entrepreneurial dream — publishing a consumer women’s shoe magazine, Shoed-In. Now she has no health care coverage.

Impact of ACA: As of Jan. 1, Buckingham will be required to buy health insurance or face a penalty. She could get a low-cost catastrophic health plan on the exchange for about $150 a month, or she could buy better coverage for between $200 and $250 monthly. Her income varies, but it’s likely to be too high for her to qualify for a tax credit to help cover premiums.

Buckingham’s view: I have friends who might be unhappy with their job but they stay because they have kids and can’t afford to quit and give up the benefits. They can’t take the risk. I knew if I left I would have a hard time getting insurance. Health care was a big part of a tough decision. But I felt I’d rather take the chance now at a young age rather than when I was older.

I could have kept health insurance through COBRA when I quit my job, but I couldn’t afford the payments. I’d be picking between health and food. I’m a little bit nervous about not having insurance. Not by any stretch of the imagination do I think of myself as bulletproof. But I decided to put it in God’s hands. It’s actually caused me to become more educated about home cures. And I’ve gotten more creative with things like buying glasses. I go online and only pay for the cost of the exam, and I get the glasses free.

It’s a real fear of mine having a big medical problem. I know some hospitals with programs where they treat you on an income-based scale. That would pretty much be my plan.

I’m going to look at the exchange and see what the price is for insurance for me. If it doesn’t work out for me this first year to buy it, the $95 (penalty) is not a lot. I do plan to get it in the next few years, though. The price is just going to go up. I do hope the Affordable Care Act makes good on the “affordable care” part.

Cassie Pirkle

Age: 25

City: Marietta

Situation: Like a lot of young adults, Pirkle has benefited from the provision of the law that enables her to stay on her parents’ policy until age 26. She turns 26 in November and now has a job that offers benefits.

Impact of ACA: Pirkle will be required to have insurance or pay a fine beginning next year. If it turns out that her employer’s plan costs her more than 9.5 percent of her income, she will be able to shop on the exchange for a better deal and perhaps receive a federal tax credit, depending on her income.

Pirkle’s view: I was worried because I had been working as my grandmother’s caregiver the last two years and I didn’t have benefits through a job. And I know anything can happen at any minute.

I wanted to end up working in education in some way, but a lot of jobs in day care centers and in pre-schools don’t necessarily offer benefits. That was one of my hoped-for job requirements.

Then I got an interview for a job as a pre-school teacher. I said that I had no minimum pay requirement, and that I would work retail on the weekends if I needed to. I just mainly needed benefits. I was worried about my birthday coming in November.

I got the job.

I started working full time at the day care center in July and I will be eligible for their health care plan at the end of October, just in time for my 26th birthday.

I was so relieved.

Problem solved!

I would have gotten insurance anyway. My parents would have pushed it so hard. Besides, I catch colds so often and get sinus infections. Those things can get ugly. I just don’t like dealing with sickness. And I like to know what’s coming up. I’m a planner.

Elle Kane

Age: 27

City: Atlanta

Situation: Kane is a self-employed nanny in good health. That hasn’t kept her from buying her own insurance — since she was 19 — which she believes is the responsible choice. She pays $147 a month for a policty with Blue Cross and Blue Shield of Georgia and notes that she has changed insurers every few years to get a better deal.

Impact of ACA: Like many 20-somethings, Kane is likely to face higher premiums under the Affordable Care Act. A plan similar to the one she has now is likely to cost about $250 a month. Because she could buy a middle-of-the-road “silver” plan for less than 9.5 percent of her income, she’s not likely to qualify for a tax credit to help pay for her coverage next year. She could, however, keep her premiums about the same if she is willing to opt for a “catastrophic” plan with a deductible of $6,350. A catastrophic plan is what it sounds like: insurance that covers you in the event of a catastrophe that runs up massive bills.

Kane’s view: When I decided to not go back for sophomore year of college, I had to start paying my portion of what my parents were paying for our insurance. Then I had to find my own plan the next year. My parents didn’t give me a choice. They said you never know what will happen. You have to be covered, no ifs, ands or buts.

I’m not worried about the little things. But I’m like, what if I get cancer?

I had Humana briefly and I am shopping plans with Kaiser. I have to shop plans because I have to change every few years to get the best deal.

I wonder why am I getting charged so much when I’m not using it. And I don’t drink or smoke, I don’t do recreational drugs and I’m not a partier. I never get sick and I only go to the doctor for yearly physicals and gynecological appointments, which are covered. But it still costs a lot for me. I get penalized because people in my group don’t make health choices.

My copay is $35 and my deductible is $3,500. Anything lower and I couldn’t the monthly premium. I got a letter from my provider saying my plan wasn’t going to go away because of the Affordable Care Act. I don’t want to be assigned a plan. I will drop it if I have to pay a ridiculous amount every month.

I don’t know anything about the exchanges. I honestly don’t want anything to do with government programs when it comes to my medical care.

I don’t think you should get fined if you don’t take care of yourself. But it’s the adult thing to do. It’s being responsible.

I don’t buy a bunch of new outfits every month, either; lots of women my age spend their extra income on fashion, and that is something that I deem not as important as health insurance.

It’s about making choices and not throwing away money on frivolous things.

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