Unhealthy Cuts

Text of an OpEd I wrote that didn’t quite pass muster with the KJ/Morning Sentinel folks, alas.

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The Maine legislature just gave our low-income high school seniors a nasty graduation present by voting to take away MaineCare health insurance from over 7,000 19-20 year olds. Those young adults, who collectively face both mounting student debt and unemployment rates more than twice as high as the average Mainer’s, will now have to take on additional financial risk.  Most who lose this safety net will not be in a position to get another form of insurance. This leaves them vulnerable to the consequences of untreated illness – lost time from work and school, damaging their future prospects –as well as the possibility of incurring bankruptcy from medical debt. By deciding that passing tax cuts was more important than fulfilling promises to our young people, Maine’s legislators undermined the very people we need to support most right now.

Things are already hard enough for financially disadvantaged young Mainers. Young people are substantially less likely to be employed than the average adult since the employment of younger adults has lagged behind the rest of our economic recovery. According to the Maine Department of Labor, the 2011 unemployment rate for Mainers over 35 was under 7 percent, but for Mainers between 20 and 24 it was over 16 percent. The unemployment rate for men in that age group was nearly 20 percent: 1 in 5 young men are unable to find work. This has a lot to do with the kinds of jobs that were lost during the recession. Many of the jobs that we lost during the recession were jobs that required only a high-school education – jobs that could have been done by these young adults. Meanwhile, when young adults are employed, they are less likely to have access to the kinds of jobs that provide health insurance.  The main growth areas in Maine’s economy require post-secondary education. While many of these are good jobs, that’s cold comfort to 19 and 20 year olds who haven’t got the credentials to be eligible for these jobs featuring employer-sponsored health insurance.

When the legislature decided to save money by cutting young adults, they ironically cut MaineCare’s least expensive group. Covering young adults is much more affordable for the state than for any other group of people. They are less likely to be seriously ill, which means that they are a better insurance bet for their insurers – including for state insurers. Nonetheless, like all other groups of people, young adults sometimes become sick or injured. When this  happens, they are less likely to get timely and appropriate care if they are uninsured. According to the Kaiser Low Income Coverage and Access Survey, uninsured low-income young adults are twice as likely as their insured counterparts to have delayed or forgone care when they thought they needed it. Those decisions not to get care had consequences. Among those who delayed or never got care, nearly half saw their conditions get worse or cause significant pain. More than a third lost time at work or school because of their lack of access to health care.

Additionally, while covering this group is less expensive than the average group of enrollees, leaving our young adults vulnerable to illness or injury can have serious financial consequences. Uninsured young adults risk bankruptcy if they run up medical debt to pay for treatment. Medical debt is the largest source of bankruptcies in the country and young adults are as vulnerable to this as anyone. Even where young adults aren’t bankrupted, a major medical expense has serious and lasting financial effects. Like most people, uninsured young adults are most likely to try to cope with their medical expenses by accruing credit card debt. According to the organization Demos, low and middle-income young adults who have tried to cover medical expenses with credit cards have levels of credit card debt 79% higher than the same group without medical debt.

With the legislature’s reckless decision to remove MaineCare coverage from around 7,000 19 and 20 year olds, we’ve created additional road blocks for young people just getting started in a tough economy. While the legislature provides tax cuts to people who’ve already made it, we ensure that more of our future entrepreneurs, small business owners, educators and community leaders will never get the chance to reach their full potential.  Taking health care access away from our young adults is one sure way to diminish Maine’s future.

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