A poll of students in three schools released yesterday by officials at California State University at Los Angeles shows that the number one barrier to getting health insurance is affordability and that an overwhelming majority of college-age students in the CSU system want health coverage and think it’s valuable to them.
One common belief about why healthy young people — known as “young invincibles” — don’t have health insurance is because they don’t really feel they need it. That notion is not supported in yesterday’s poll results, said Walter Zelman, chair of the Department of Public Health at CSU-LA.
“I think this poll may shed more light on what ‘young invincible’ may mean,” Zelman said. “Our students are saying the reason they’re uninsured is they can’t afford it. [Health insurance] is not as high on their priority list, that’s true, but it’s not that they feel they don’t need health insurance.”
Zelman polled students from three schools in the CSU system — Los Angeles, San Jose and Fresno. He used financial aid data to determine eligibility for subsidized coverage. He said about 30% of the students polled did not have insurance and another 13% had insurance within the individual market — making them prime candidates for either expanded Medi-Cal coverage or for coverage through Covered California, the state’s new health benefit exchange .
“Most of our students work and many have family responsibilities,” Zelman said. “These are not your typical Stanford or UCLA kids, who are all getting health insurance. These [CSU students] just feel they can’t afford it.”
But many of them actually can afford it, Zelman said. Looking at the overall population of those students receiving financial aid, about 35% of them are eligible for Medi-Cal, and another 40% of them would be eligible for exchange subsidies, Zelman said.
“So for these students, not only if you make it affordable but if you also make it easy to access coverage then we’ll see a healthy response,” Zelman said.
That’s a big task for the exchange and for state Medi-Cal officials, to get students to understand that affordable coverage actually is available to them. But the effort carries the prospect of a big payoff with thousands of young, healthy people to enrich the state programs’ patient mix.
“There are about 431,000 students in the CSU system. It’s the largest university system in the country,” Zelman said. “And the vast majority of students in these systems meet the criteria for needing [Medi-Cal or exchange] insurance.”
This is one segment of the population that stands to benefit greatly from the Affordable Care Act provisions, he said.
Zelman said college-age Californians benefit in three main ways from the ACA:
- Subsidies: “The subsidies are very generous. They make what was unaffordable affordable. And when it’s affordable, we’ll see this ‘young invincibles’ idea set aside. It’s the money, not the invincibility,” Zelman said;
- Medi-Cal expansion to childless adults; and
- Extended parental coverage: The ACA allows young people to stay on their parents’ insurance until age 26.
“That’s the positive story for the ACA,” Zelman said. “The numbers are there. There’s a lot to offer in those three things.” Getting young people’s attention on this issue is the next big step, he said.
“Given the number of things these students have on their plates, it’s going to take more time and effort to get them enrolled,” Zelman said. “The state is trying and Covered California is trying. It won’t happen overnight but over time, it will happen. Over the next two or three years, this will all be standardized.”