Blog - Health Insurance Versus 3D TV

The individual mandate is one of the most controversial provisions in the Patient Protection and Affordable Care Act (ACA).  In 2014, everyone must have health insurance coverage or pay at least a $95 fine.  This provision is necessary to make sure that both healthy and sick individuals are in the insurance pool, which helps to keep premiums down.  If only sick people were insured, premiums and health care costs would increase astronomically.  Therefore, a pertinent question exists: how can we ensure that healthy, young individuals buy health insurance instead of paying the fine or getting insurance only when they get sick?

Luckily, I am a healthy 23 year-old male, without a negative medical history.  For several months after I graduated from college, I felt "young and invincible," and, therefore, did not get health insurance.  After college, I was a tennis instructor, teaching over ten hours a day both in the un-air-conditioned club and outdoors in the scalding heat.  Whenever I felt a little pain in my leg or got a headache, I would take some ibuprofen and continue.  After some time, I realized my stupidity – I could tear my ACL or suffer a heat stroke; and then what?  I decided to buy health insurance – with a monthly premium of $150.  My risk aversion convinced me to buy insurance.  But, what will motivate others?

As a Rogers Memorial Scholar at the National Coalition on Health Care, I have attended several health care reform panels, which discussed how to get healthy people to buy health insurance.  At baseball games in Massachusetts, announcements are made proclaiming, "[g]etting health insurance is cool!"  Other approaches focus on one's moral obligation to buy insurance in order to keep coverage affordable for everyone. 

Personally, I will never again be without health insurance; the fear of living an active life and getting injured was enough for me.  But, let's be honest – how many young adults would look at the cost difference – a possible $95 fine versus a $150 monthly premium – and choose the more expensive option? 

Look at what happened when Massachusetts implemented a similar set of reforms: within six months of getting insurance, 17,177 people dropped their coverage (compared with 3,508 people who did so prior to the reform).  Now people in Massachusetts are only buying insurance after they need it. 

By taking the risk, when the mandate becomes law in 2014, one could save enough money to buy a new 3D TV and be the coolest kid on the block.  With the next World Cup starting that summer, the new TV is an attractive option.  So, the question remains – what else will encourage young adults to buy health insurance?

The best suggestion is to tell the truth:  ACA mandates that health insurance coverage include preventive care services without a co-pay.  Such services help young adults to ward off serious ailments, such as diabetes or cancer.  Is saving some money today worth suffering from such diseases later?  Moreover, the risk involved in not buying insurance increases over time, with the "no-health insurance fine" substantially increasing each year; in 2016, the fine will be at least $695.

If that is not convincing enough, young adults should buy insurance because, while health insurance companies must accept everyone, ACA does not regulate the length of waiting periods in the individual market.  Therefore, insurance companies may subject individuals to extended waiting periods before providing benefits. 

Young adults must understand a few things before choosing to flaunt the law and not buy health insurance.  First, individuals may be unable to get health insurance when they need medical services; at that point, it may be too late because they may have to wait months before they are insured.  Second, insurance companies may be able to base the waiting period on one's health status, meaning that individuals with a pre-existing condition who fail to buy coverage may wait longer.  The bottom line is: by the time one thinks he will need insurance, it may take months to get it.

Don't forget that any medical bill that accrues while you don't have health insurance is on your tab.  What if that cough is more than a quick fix ailment; was that new 3D TV really worth the risk?

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