One of the most popular features of the Affordable Care Act (ACA) was ensuring coverage of children on their parents’ health insurance up to age 26. These young adults are often called the “young invincibles” and are a segment of our population that previously was largely uninsured.
Now that this group of consumers is becoming an active participant in the health care system, we in the health services field must do our part to help educate them about how to choose and use their health insurance and health care providers and become informed health care consumers. As Second Lady Dr. Jill Biden recently noted at a young invincibles enrollment event in Arlington, Va., the time for young adults to sign up for health coverage is now.
“Many of my students worry about their health, worry about not having coverage and worry about cost,” Biden said.
Now that many uninsured young people nationwide can get coverage for $50 or less a month, making health care more accessible to them, we must ask ourselves if we are teaching them to use health care responsibly. For example, do they know how to use their health care options preventatively, instead of only in an emergency? And how many of these new consumers have learned how to choose a health care provider based on the quality and value of the services?
The ACA presents a tremendous opportunity for all involved in the health care system – including carriers, providers, consumers and family members – to teach this next generation of health care consumers the fundamentals of managing their health care, such as:
- The basics of health insurance. What are co-pays, deductibles, ER visit charges and networks? And what are the differences between “in network” and “out of network” providers? Young invincibles will also need to learn how to read and understand an Explanation of Benefits (EOB).
- Preventative care. After all, how many of us in the older generation actually got annual physicals when we were in our 20s and 30s?
- Chronic conditions. When they are younger and healthier, they should identify and manage emerging or existing chronic conditions to increase their long-term health and prognosis.
- Medical home. Young invincibles should understand the importance of establishing a medical home or a relationship with a primary care provider. This includes how to choose a primary care provider, as well as understand quality metrics and how they can be used to assist with provider selection, and how to get assistance regarding what providers are in their network.
For families that are adding their adult children to their health insurance in states with Medicaid Managed Care Enrollment Brokers and/or that call the toll-free phone number that supports Healthcare.gov, we have a unique opportunity to provide a “teachable moment” on important topics such as regular checkups, screenings, and where to go if you are injured. (Hint: it may not always be the emergency room!) We also need to educate the young invincibles on the importance of maintaining coverage once they are no longer eligible for health insurance via their parents’ coverage.
The delivery system will change as consumers change their expectations and demands for care. These young adults will be the consumers of health care and an important element in actuarial pricing for many years to come. It is essential that they develop good habits for choosing quality and valuable services. With health insurance coverage within their reach, now is a critical time to teach this new generation of health care consumers how to “choose and use” their insurance and providers in order to create a sustainable health care system for us all.