Navigating the Affordable Care Act – Why “Young Invincibles” Need It

In preparing to write this “Young People’s ACA” post, I called a young attorney in hopes that she would clue me in to what a younger-than-me solo or small firm attorney would be thinking. She reminded me that the younger-than-me set feels invincible. “Really?” I wanted to ask. “Is that still true?” It is — and it always will be, according to my youthful cohort, for many in the younger set. (I refuse to use the “Gen-X/Gen-Y/Millennial” terms. It’s like categorizing people by their astrological signs to me.) This view made me feel more than ever like the harbinger of doom. I started looking up accidents and youth in our region. That turned dismal abominably quickly.

Is there any other way for me, a slightly older lawyer (though very youthful-older), to write this article? Carol M. Ostrom of the Seattle Times angled in with the mother position (see no. 7). But she was literally speaking to your mothers, not you. Besides, I think you already know that bad stuff can happen to young people. The 18-to-34 age bracket is one of the heaviest users of emergency rooms. Things happen and we need health insurance, more when we are older, but sometimes when we are younger, too.

Instead, I decided to appeal to your Good Samaritan natures (see no. 5). The older folks in the insurance pool need you. Fact is, the pool does not work if it gets laden down with expensive older people. The price will go up and up and up to match their medical needs (i.e., medical costs) unless the younger, healthier set join the pool and even out the population’s medical needs. This is why health insurance is mandatory under the Affordable Care Act: It is not sustainable any other way.

But you may still have trouble affording it, even under the Marketplace. Here are some points of relief:

1. You may be eligible for your parents’ health plan.

If you are under 26, you can likely get coverage under your parents’ health plan, even if you are in school, not living with them, eligible under an employer’s plan, financially independent from your parents, and/or married.

2. You may be eligible for Washington Apple.

When that coverage ends, depending on your income, you may be eligible for Washington Apple under Medicaid expansion (if you are making $15,300 or less as a single individual), or for tax credits that help you pay the premiums (400 percent of poverty level and lower, or about $45,960 a year for single individual). Calculate your subsidy so you know what to expect.

3. You may be eligible for a catastrophic plan.

If you are under 30 years old or you can prove hardship (yes, mountainous student loans may be a grounds for hardship if it means the lowest-priced coverage available to you would cost more than 8 percent of your household income), you may purchase a catastrophic plan with lower premiums and very minimal protection. It will cover three doctor visits per year and certain free preventative benefits, with a large deductible that will likely match your maximum out-of-pocket costs. In other words, lower premiums give you less coverage that only addresses the worst-case scenarios.

Catastrophic plans are offered to 30-and-under folks because you are less likely to have worst-case scenarios. But you will have them at some point in life, so this is not where your coverage should stop. Eventually, you should work towards getting a more robust health plan.

Tell us what you most want to know about the ACA today by commenting or emailing us at lomap@wsba.org. We will do our best to incorporate your questions and feedback into this ongoing Navigating the ACA series.