Young Adults Plan Coverage Disappears When You Get Sick" by John McDonough

The Connector Authority is heralding the "Young Adults Plans" (health insurance plans available through the Connector for 19-26 year-olds) as an affordable insurance option for young people. Advocates are questioning the adequacy of these plans. Who's right?

The plans are cheap - in price and value. Young Adult Plans (YAPs) have extremely slimmed down benefit packages. Most alarming - they may contain annual benefit caps. Emergency regulations released by the Division of Insurance on April 17 allow YAPs to limit coverage to $50,000 per year, leaving insured young adults with zero coverage for catastrophic health care needs.

Seem to us this defeats the purpose of insurance.

At its essence,
insurance exists to protect people from financial risk and barriers to care in the face of serious illness or injury. It's appealing - and
wrong - to think young people don't get sick or injured. Young adults are not immune to accidents or chronic disease, such as hemophilia, HIV, cancer, mental illness and diabetes. Treatments can cost tens to hundreds of thousands of dollars annually.

Failing to provide coverage for catastrophic health care needs can leave individuals exposed to tremendous costs. Young adults who exceed an annual benefit cap will face life-altering consequences: the loss of coverage will leave them exposed to huge medical bills, leading to medical debt and personal bankruptcy and barriers to care. Insurance will have failed them, leaving a financial crisis on top of a health care crisis.

The Division of Insurance must fulfill its role to protect consumers
from unfair and inadequate coverage. The Division and the Commonwealth should not support cost-sharing mechanisms that undermine young adults' health and financial stability. The Division should not design cheap insurance plans that stop working when people get sick.

John McDonough
Executive Director, Health Care for All