New Health Plans Limit Young Adult's Coverage

In testimony before the Health Care Connector Authority today, a Boston-based health research and advocacy group, the Access Project, urged the legislature to remove coverage caps and decrease deductibles on the new health insurance plans aimed at young adults and low-income residents.

In an attempt to keep premiums low, the current plans for people between the ages of 19 and 26 are limited to $50,000 or $100,000 in annual coverage. Analysts at the Access Project are concerned that these coverage limits could result in an unfair burden for young adults.

"If they get seriously ill, with caps like these, it will be easy for them to be socked with bills that they can't possibly afford to pay," said Carol Prior, an Access Project policy analyst. "If you become seriously ill, a $50,000 cap doesn't take you very far. You'll exceed it rather quickly. That's a very serious problem."

Young adults are more likely to be uninsured than any other age group in the state. For that reason, legislators created special, low-cost plans designed to appeal to young people who might otherwise continue to forego health insurance. These plans were modeled after the coverage that many Massachusetts students have had to purchase since 1989.

But Prior points out that young people rarely incur the kinds of high medical bills that can bankrupt insurers.

"It's hard for me to understand why the insurers would say that, if there are so few people who reach the cap, why they need to include it to make the plans supposedly affordable," Prior says.

Statistics based on insurance claims show that only one percent of the young adult population ever exceeds $50,000 in annual medical costs.