A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Want To Lower the Number of Uninsured? Look at the 19-21 Age Group

Want To Lower the Number of Uninsured? Look at the 19-21 Age Group

October 23, 2009


Think back to when you were 19. Were you a freshman in college? Living in your first apartment? Working your first full-time job? Living at home with your parents?

There are certain age milestones in all of our lives. For many, their late teen / early 20s are ones of transition. With all the changes going on in their lives, making informed, well-reasoned decisions about health coverage is difficult, if not impossible.

When the Legislature passed Health Reform in 2006, they recognized the often tumultuous nature of these years and extended the age when children could be on their parents’ employer-sponsored health insurance to age 26.

Although this was an important step, there are many young people for who this is not an option.

Low income children (under 300% of the Federal Poverty Level) are eligible for coverage under MassHealth through age 18. However, the current statute ends their MassHealth eligibility once they turn 19.

For many reasons, it makes sense to extend the age of MassHealth eligibility.

First, there is the issue of continuity of care. With all the changes going on in young people’s lives during these years, allowing them to maintain their coverage and their doctors until a point when they are more settled just makes good sense.

Second, there is the issue of cost. Although Young Adult Plans (YAPs) were established through Health Reform, the out-of-pocket costs for young people are higher for subscribers. In some cases, premiums for YAPs are $78 per month higher than they would be under MassHealth.

In this time of economic and budgetary crisis, this is actually a low-cost fix for the Commonwealth. Because of federal matching funds available through Medicaid, much of the cost burden of this expansion would be borne by the federal government rather than the state. And Massachusetts wouldn’t be breaking new ground here – 16 other states make 19-21 year olds eligible for Medicaid.

Finally, expanding MassHealth takes on the issue of the uninsured head-on. While we have made remarkable progress in reducing the number of individuals without insurance, young people remain disproportionately uncovered. While young people from 18-24 represent 12% of Massachusetts’ population, they make up 24% of our uninsured.

This morning, the Joint Committee on Public Health heard testimony in support of SB 54, An Act Ensuring Basic Health Care For Children And Young Adults. This legislation would expand MassHealth eligibility up to age 21 from 19.

Testifying in support of the bill was Dr. Cathryn Samples, an Adolescent Medicine Specialist at Children’s Hospital Boston. She spoke powerfully about the challenges facing many of her patients and how allowing them to remain on MassHealth coverage would make a difference in their lives.

Huge thanks from the Children’s Health Access Coalition to Dr. Samples for her testimony.

Being in your early 20s can be an overwhelming time. Life is full of change and new experiences. When you are also low income, it can be even more difficult. Passing and enacting SB 54 would make things just a little easier.

Matt Noyes
Policy Manager