Healthcare Issues Among Millennials

Transamerica Center for Health Studies (TCHS) finds that Millennials are struggling with the cost of healthcare while facing some health issues at a young age. The survey reveals the following:

  • The most common reason that the 11% of uninsured Millennials didn’t get coverage before the ACA deadline is that they did not know how to apply for insurance.
  • 60% of the uninsured are women; and 68% of the uninsured are unemployed.
  • 21% of Millennials can’t afford their routine healthcare expenses. An additional 26% can afford it, but with difficulty.
  • 70% say that cost is very important when looking for healthcare.
  • 66% of Millennials say that a $200 a month premium is not affordable.
  • Nearly half of Millennials skip care to reduce their healthcare costs.
  • More than half of Millennials have a chronic illness or health condition. The most common conditions are depression (17%), weight issues (15% overweight and 7% obesity), and anxiety disorders (14%).
  • 64% rely on their mom/step-mom as their primary source for health advice and healthcare guidance; 36% rely on their dad/step-dad; and 26% rely on their spouse or partner.

Obamacare Significantly Reduces Cost of Mental Health Care for Young Adults

The Affordable Care Act (ACA) has significantly reduced out-of-pocket behavioral health care costs for adults 19 to 25, according to a study published in the Psychiatric Services Journal. Young Latinos, African Americans, and other racial and ethnic minorities saw the greatest reduction in out-of-pocket behavioral health expenses. This demographic often has higher unemployment and lower salaries, so they are less likely to seek behavioral health services. The ACA’s dependent coverage provision has reduced the number of uninsured young adults by at least three million. The ACA allows young adults to remain on their family’s health plans until they turn 26. Because of this, the expansion of health care access is also expected to increase the number of users of mental health and substance abuse treatment services. Behavioral health conditions often emerge during the 19 to 25 year age range. Also, this age group has a higher rate of serious mental illness than other adults.

Costs and Eligibility Are the Biggest Barriers for the Uninsured

Two-thirds of uninsured Californians were eligible for coverage in 2014, but most said they did not enroll because of the cost. The remaining third were ineligible for coverage under the Affordable Care Act due to their immigration status, according to a study by Berkeley’s Center for Labor Research and Education and the UCLA Center for Health Policy Research. The study finds uninsured Californians fall into four groups:

  1. Undocumented residents 32%: Residents who don’t qualify for health coverage under the Affordable Care Act are predominantly low-income, Latino, and have limited English proficiency.
  2. Those eligible for Medi-Cal 28%: Adult citizens and legal immigrants with incomes at or below 138% of the federal poverty level and children at 266% of the poverty level.
  3. Those eligible to buy health coverage through Covered California with a federal subsidy 31%: Citizens and legal immigrants with incomes from 139% to 400% of the poverty level.
  4. Those eligible to buy health coverage through Covered California without a federal subsidy 9%: Citizens and legal immigrants with incomes above 400% of the poverty level, which disqualifies them from federal subsidies.

The largest percentage of citizens and legal immigrants (46%) cited cost as the main reason for being uninsured. Miranda Dietz, a researcher at UC Berkeley said, “We’re a relatively high cost-of-living state. It’s no wonder that some Californians, who may be unaware they qualify for health subsidies and other programs, still find the cost of health insurance out of reach.”

California has more than 1 million undocumented immigrants who don’t benefit from the Affordable Care Act. Nadereh Pourat, director of research for the UCLA center said, “Hundreds of thousands of men, women and children, not to mention the workers who power California’s economy, are one health emergency away from potential financial ruin because they lack insurance. From an economic perspective, it’s bad business to rely on workers and then not offer them equal health protection. And from a humanitarian perspective, it’s just wrong.”

UCLA and UC Berkeley also collaborated on a related on Medi-Cal study. About one-third of those who were uninsured, but eligible for Medi-Cal thought they were ineligible or didn’t know if they were eligible. Another 20% said they were getting insurance, reflecting a major backlog during the first year of processing applications, which has largely been resolved since then. Both studies were funded by the Blue Shield of California Foundation. The study notes that many previously uninsured Californians have enrolled for coverage, but fully covering those still uninsured will require changes in policy to improve affordability and expand eligibility.

The Costs of Caring for Newly Enrolled Individual Members

Individuals who enrolled in Blue Cross and Blue Shield (BCBS) health plans after the Affordable Care Act (ACA) took effect have higher rates of disease. They also received much more medical care than did those who enrolled in individual plans before 2014. The study finds the following:

  • Members who were newly enrolled in BCBS individual health plans in 2014 and 2015 had higher rates of certain diseases, such as hypertension, diabetes, depression, coronary artery disease, HIV, and Hepatitis C.
  • New enrollees received much more medical care than did those with BCBS individual plans before 2014 who maintained BCBS individual health coverage into 2015, as well as those with BCBS employer-based group health insurance.
  • New enrollees used more medical services including inpatient admissions, outpatient visits, medical professional services, prescriptions filled, and emergency room visits.
  • Medical costs of care for the new individual market members were 19% higher than employer-based group members in 2014 and 22% higher in 2015. For example, the average monthly medical spending per member was $559 for individual enrollees versus $457 for group members in 2015.

Alissa Fox, senior vice president of the office of policy and representation for BCBSA said, “Better communication and coordination is needed so that everyone understands how to avoid unnecessary emergency room visits, make full use of primary care and preventive services, and learn how to properly adhere to their medications.” BCBS companies are expanding prevention, wellness, and coordinated care programs. Fox said that these programs have helped BCBS companies reduce emergency room visits, hospital admissions and readmissions, and hospital infection rates. There have been measurable improvements in prevention, including improved cholesterol control, better adherence to best practices for treating diabetes, and higher rates of screenings and immunizations.

Millions Remained Uninsured in California

 

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The Affordable Care Act (ACA) helped lower the uninsured rate in California from 16% in 2013 to 11% in 2014, but 3.8 million Californians under 65 remained uninsured. The California HealthCare Foundation released the following statistics on who gained coverage in California:

  • Californians age 21 to 24 experienced the largest drop in the number of uninsured from 25% in 2013 to 16% in 2014.
  • 25% of the state’s remaining uninsured were 25 to 34, and 57% were Latino.
  • About 13% of the employed population were uninsured.

For more information, visit www.chcf.org/almanac.

The Majority of Uninsured Americans Have a Chronic Condition

Sixty-two percent of Americans have been diagnosed with a chronic health condition, according to a survey commissioned by the Transamerica Center for Health Studies. The most common conditions are being overweight, having high blood pressure, and having high cholesterol. The study finds the following:

  • 82% of Americans say they can afford routine health expenses compared to 41% of the uninsured. However, 41% report an increase in premium costs over the past one to two years.
  • 71% say they can afford a $100 monthly premium.
  • 66% say they can’t afford a premium of $300 or more per month.
  • Since the implementation of the Affordable Care Act, the number of uninsured Americans has dropped from 21% in 2013 to 11% in 2015.
  • 82% of Americans are very or somewhat satisfied with the healthcare system, compared to 73% in November 2013.
  • The most common reason cited among for not getting health coverage is low awareness of the ACA insurance mandate (26%). Eighteen percent do not know how to apply, and 21% are willing to pay the tax penalty for not having health insurance.
  • 30% of  Americans say the ACA directly affected their health coverage; those who did tended to report a positive effect.
  • 48% have no strong opinion of the ACA.
  • White Americans (67%) are most likely to are diagnosed with a chronic health condition.
  • African Americans have the highest rates of high blood pressure and Type 2 Diabetes (24% and 10%, respectively).
  • At 41%, Asian Americans are the least likely to have a chronic health condition.

California’s Uninsured Rate Plummets

California’s Uninsured Rate Plummets
California’s uninsured rate dropped to 12.4% in 2014 from 17.2% in 2013, according to a recent Census report. “Covered California executive director Peter Lee said, “California is having one of the largest impacts in the nation on reducing the rate of the uninsured.”  The Census report comes on the heels of a field poll in which 68% of registered voters said that California had been successful in implementing the new law.

Lee noted that California has embraced the Affordable Care Act, including expanding Medi-Cal and establishing a health exchange that has all the tools available to provide coverage and care to millions. California still has millions of people who are eligible for health insurance through Covered California or Medi-Cal. “We cannot rest on our laurels. You don’t change overnight from a culture of coping, where people think they can’t afford coverage and make do without care, to a culture of coverage,” he said.

Fresh Data on ACA Show the Effects of Health Reform

The uninsured rate reached a new low in the first full year of the ACA health insurance marketplace operation. A smaller share of Californians delayed or skipped necessary medical care, according to a survey by the California HealthCare Foundation (CHFC). The survey also found the following:

  • The number of uninsured Californians under 65 dropped 12%, falling from 16% of the population in 2013 to 14% in 2014, a new low.
  • Notable decreases in uninsured rates were found among people living below 138% of the federal poverty level and among African Americans.
  • The share of the population age 18 to 64 enrolled in Medi-Cal rose by 52%.
  • The share of uninsured Californians reporting cost as the reason for lacking coverage dropped from 53% to 43%, although lack of affordability remains the most common reason cited for going without insurance.
  • Most non-elderly adults who went without necessary care said it was because they couldn’t get an appointment.
  • In certain regions, such as Northern/Sierra counties, more people had a hard time finding primary care physicians and specialists who accept new patients or their insurance than in 2013.

A Look At Healthcare’s Super-Utilizers

The need is intense, yet temporary for many patients who use a lot of health care services. These patients with multiple visits to the emergency room and multiple hospital admissions are known as “super-utilizers.” They have become the focus of community- and primary care–based interventions.

Health Affairs looked at 4,774 publicly insured or uninsured super-utilizers from May 1, 2011 to April 30, 2013. Three percent of adult super-utilizers accounted for 30% of adult charges. But fewer than half of patients who were super-utilizers on May 1, 2011 remained so seven months later. Only 28% remained at the end of a year. Solutions to over-utilization include improving predictive modeling to identify people who are likely to experience sustained levels of avoidable utilization, better classifying subgroups for interventions, and implementing stronger program evaluation designs.

Some taxpayers will get special ACA open enrollment period

Uninsured tax filers in states using the federal exchange who were unaware they would be penalized for not having health insurance will get another chance to enroll, the Obama administration announced. The special enrollment period will be from March 15 to April 30. The IRS is also sending new forms to about 800,000 tax filers to correct subsidy errors. Reuters (2/20), The Washington Post (tiered subscription model)/Wonkblog (2/20)

Last Updated 09/22/2021

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