Dear Young People: Please Sign Up for Health Insurance

Stop playing Russian roulette with your health. has delayed the enrollment deadline from Dec. 23 to 11:59 p.m. on Christmas Eve.
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In recent months, we have witnessed much hand wringing over whether the Affordable Care Act can survive unless more healthy young people sign up, given their currently low participation rates. My concern is a different one: the enormous risks to young people — the so-called "young invincibles" — who opt to go uninsured. The ACA may survive just fine, but many of those uninsured young people will not.

As a nurse for almost four decades, I know that too many young people and their families suffer from serious health problems, health care debt and despair. Their stories disturb me. The uninsured musician struggling to pay for treatment of recently diagnosed leukemia, unable to play gigs and earn even his basic livelihood let alone the costs of chemotherapy treatment and bone marrow transplant. The young woman who broke and lost her front teeth in a bicycling accident and spent years trying to fund not only new teeth but the repair of a less than optimal outcome incurred in the emergency department of a public hospital, the only place she could go as an uninsured person.

[See a collection of political cartoons on Obamacare.

These risks are not simply anecdotal.  While statistics vary, there is much evidence of the significant health risks facing young adults between the ages of 18 and 34. Almost 13 million of them account for more than 27 percent of non-elderly uninsured persons in the United States, and close to half of uninsured young people have a hard time paying medical bills. Each year, young adults account for nearly a quarter of the 129 million emergency room visits in the United States, second only to persons over the age of 75, according to the U.S. Department of Health and Human Services.

Consider the following facts:

  • Young adults have all sorts of accidents due to sports, physically demanding jobs and just moving fast through life. Three-quarters of all deaths of young adults are due to injury or violence, leading with motor vehicle crashes, followed by homicide and suicide. Motor vehicle crashes are the leading cause of death for 15-24 year olds, due to speeding and distractions such as texting and drinking alcohol.
    • Overall, young adults are disproportionately burdened with sexually transmitted infections, accounting for countless emergency department visits, prescriptions and possible long-term fertility consequences. Most young adults have sex and are likely to have multiple partners; they are in need of contraceptives, STI treatment and safe sex practices.
      • Young adults experience depression, anxiety, have thoughts of, and attempt, suicide in high numbers. Untreated mental illnesses contribute to a great deal of suffering in addition to multiple emergency department visits, loss of wages and sometimes, violence. The recent anniversary of the Sandy Hook murders and more school gun violence continue to point to our tremendous need to provide teens and young adults with mental health services.
        • One in every six young adults has a chronic illness such as diabetes, cancer or asthma that requires health care services on a regular basis.
        • [See a collection of political cartoons on the economy.]

          So, to all of you feeling invincible out there, I would say: I wish you didn’t have to do this. If you’re like my two kids, ages 24 and 27, or my students, or their friends out there working or trying to find a job, you already have more than enough on your plate. I look forward to the day when health care in the United States is recognized as an essential element of our social contract. That is something I am working for — and I invite you to join me.

          However, that day has not yet come. For now, unless you are fortunate enough to be covered by a parent’s insurance plan or your employer, you will need to step up and take action so that you will have the most effective care possible when you need it.  (You can do that here.) Take a hard look at the facts and draw your own conclusions. Your life may depend on it.