JONATHAN COHN DECEMBER 14, 2011
The economy remains weak and health insurance keeps getting more expensive, but the number of young adults without health insurance fell by 2.5 million this year.
How could that be? Simple. President Obama and the Democrats passed health care reform. And, by all accounts, it's starting to do some good.
A lot of good.
As Ricardo Alonso-Zaldivar of the Associated Press first reported on Wednesday, the Centers for Disease Control is releasing new data that shows the number of young adults, ages 19-25, without private insurance fell from about 10.5 million to 8 million between 2010 and the middle of 2011. The number of Americans in other age groups, including those between 26 and 35, went up in the same period. See the graph below, which Igor Volsky has reproduced from the administration's analysis.
Why would adults younger than 26 be so much more fortunate than those who are older? The only possible explanation, according to administration officials and most health care experts I know, is the Affordable Care Act. One of the first provisions to take effect is a requirement that insurers offering family coverage include dependents up through the age of 25.
This isn’t the first time we’ve heard about that provision having an impact: Previous estimates, public and private, had suggested at least half a million people and possibly many more had gotten health insurance thanks to the young adult provision. These latest numbers from the CDC, according to the administration, are more precise than those previous reports. (Even if subsequent analysis suggests the 2.5 million figure is high, it's clear large numbers of young people are taking advantage of this provision.)
Critics of the law, which they (and I) like to call "Obamacare," have suggested that its expansions of and improvements to health insurance are not worthwhile because of the expense they inevitably impose. And it's certainly true that requiring insurers to cover more services or more people will, on its own, force the insurers to raise premiums. Recent private sector estimates have suggested that the law’s new requirements have raised premiums by 1 to 2 percent.
But that includes all of the early coverage provisions – i.e., not just the requirements to cover young adults but also new guarantees of access to preventative care and some prohibitions on discrimination against the sick. It should also be a one-time bump, since now those provisions are in effect.
And while the Affordable Care Act will impose many more requirements on insurers in 2014, when its full provisions take effect, the law also includes myriad efforts at cost control that will, according to the Congressional Budget Office, more than offset the cost for government without causing private insurance premiums to soar. Skeptics insist that the law's cost control incentives will fail, but already there's anecdotal evidence that the incentives are starting to have a positive effect.
Like most of the Affordable Care Act’s provisions, the requirement that insurers offer coverage to young adults is wildly popular. And that may explain why, as Volsky notes, some Republicans have stated they would keep the provision, even as they seek repeal of the rest of the law.
But that raises a question. Are young adults more deserving of coverage than older ones? Why are the Republicans so willing to jettison other provisions – like, say, the tax credits for working-class Americans who can’t afford coverage on their own, the prohibitions against denying insurance to people with pre-existing conditions, and so forth?
Keep in mind that neither the Republican presidential candidates nor Republican congressional leaders have proposed anything would come remotely close to providing the sort of benefits that the Affordable Care Act – er, Obamacare – will.
I don’t get to ask questions at tomorrow night’s Republican debate. If I did, I might try that one.