Convincing young "invincibles" to enroll in healthcare

When Ilana Valinsky got her 2015 calendar, she flipped to May and circled the 18th, the day she would receive her master's degree in social work from the University of Pennsylvania.

"I'm the graduation speaker for my class," she said last week, taking a break from polishing her speech. "That's where my focus is."

Valinsky's focus shifts this week to finding a job and health insurance. Covered by a school plan through July 31, Valinsky doesn't want to risk being uninsured for a day. And for good reason: seven years ago, her mother died from breast cancer.

"I spoke to my gynecologist," said Valinsky, 29, a Pittsburgh native living in Center City. "She informed me that I have to start getting mammograms this summer. As I get older, it's important to have coverage. It's a priority for me."

For many younger college graduates, health insurance may not be a priority. Some can remain on their parents' plan until they turn 26 or find a job with health benefits.

Others, however, will need to buy health insurance or face a penalty of $325 or 2 percent of household income when they file their tax returns in April.

"If you are graduating now, you should go into the marketplace as soon as possible and identify what you are eligible for and how you can get covered," said Neil Deegan, Pennsylvania state director of Get Covered America, a nonprofit group whose goal is to help people obtain health insurance.

Almost 132,000 Pennsylvanians and 63,299 New Jersey residents ages 18 to 34 signed up for 2015 marketplace coverage, according to government data.

College grads may qualify for a special enrollment period (SEP) to buy health insurance. The SEP allows people who have had a life-changing event, such as marriage or loss of health coverage, to buy insurance on the Affordable Care Act marketplace within 60 days of the change.

Qualifying is one thing. Persuading a group dubbed the "young invincibles" to pay for something the odds say they won't use is another. Then again, life throws curveballs - illness, accidents - that don't know about "invincibles."

"Think about a runner who takes a spill on the Schuylkill Boardwalk and breaks an ankle," Deegan said. "That is thousands of dollars out of their pocket if they don't have health insurance. If you have health insurance, you're protected."

Cost is the main reason those in their 20s give for not buying insurance, Deegan said. For them, monthly premiums are just too expensive, even though most marketplace shoppers in the area qualified for significant tax credits. In Pennsylvania, 51 percent are paying $100 or less a month after applying their subsidies; in New Jersey, 38 percent are enjoying that low payment.

The amount of the subsidy depends on income. The monthly premium is based on the plan and the amount of subsidy applied. Some college graduates may be eligible for HealthChoices, Pennsylvania's Medicaid expansion program, which has year-round open enrollment.

"So yeah, $50 or $60 a month might seem pretty insurmountable, but so does $8,000 for a hospital bill if you break something," Deegan said. "But in many cases, they need somebody they trust to tell them that it is important."

And the best people to do that, according to a 2013 national study conducted by Lake Research Partners for Enroll America, are Mom and Dad.

"It sounds cliché, but it is really true that kids do what their mothers tell them," Deegan said. "It may take a couple of Sunday dinners, but parents play a really, really important role in making sure their kids are covered."

With so many plans and options to choose from, Deegan suggests setting up an appointment with a navigator or certified application counselor to go over the basics and explain terms like deductible, co-pay and co-insurance. Help is available at the website getcoveredamerica.org/connector and through the Pennsylvania Health Access Network (877-570-3642 or info@pahealthaccess.org).

"Enrollment counselors are available and can help explain what those things mean so the person can make the best decision for themselves and for their budget," he said.

Valinsky is readying herself to buy insurance by talking to friends who have signed up. She even watched one "go through a process that was very frustrating" before he got enrolled.

"Their experience will help me make sure that I have covered all of my bases and done all of my homework," she said.

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This article was written in partnership with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.