Esther Lopez, CC ’09, has a toothache, and there isn’t much she can do about it.
When her Columbia student health insurance expired in August, she became part of one of the fastest-growing uninsured demographics in the United States: individuals aged 19 to 29.
“I’ve had to go to the doctor a couple of times already and it’s had to come out of my own pocket, which isn’t great because I didn’t have a job,” Lopez said.
She recently found work as a paralegal on Long Island, but the job doesn’t offer insurance for the first three months, leaving her cavity growing along with her anxiety.
A large portion—29 percent, or 13.2 million—of young adults aged 19 to 29 lacked health coverage in 2007, according to the latest figures from the Commonwealth Fund, a national health care advocacy and research foundation based in New York City.
“It’s a time full of transitions,” said Jennifer Nicholson, Mailman ’08 and the lead author of the Commonwealth Fund’s August report on how young people become uninsured.
The obvious solution is to find a job that provides insurance, but these days, that is easier said than done.
“Unfortunately, in this economy it takes a while to get a job,” Nicholson said. “And even if you can, it might be temporary or part-time, and those jobs are less likely to offer insurance.”
Though the recession has officially ended, the national unemployment rate topped 10 percent this month for only the second time since World War II, and nearly 80 percent of 2009 college graduates who are looking for a job haven’t found one, according to the National Association of Colleges and Employers.
In this unstable climate, recent graduates are turning to stopgap measures that are often less than ideal.
After Eric Wang, SEAS ’05, was laid off from his job as a technology consultant in February, he sought basic transition coverage from a health maintenance organization (HMO)—an organization that contracts with specific health care providers and covers only treatment those providers deem necessary for a patient.
Wang said he purchased an HMO plan for emergency and catastrophic coverage, and was shocked to receive a $4,000 anesthesia bill recently, months after he required surgery on a broken arm from a snowboarding accident.
“It was all a big hassle,” Wang said of dealing with his insurance company, which didn’t cover as much as he had expected. “I’m constantly just waiting for different bills to come in.”
But Dr. Edward Geehr, who has sat on the executive boards of several medical and biotechnology companies, said there is affordable hope for the unemployed.
“For most young adults, what you really want is financial protection from catastrophic illness or injury.” Geehr said, recommending that graduates check out Ehealthinsurance.com for quotes based on age and location. “If you don’t need much routine care, then a high-deductible plan is for you.” A deductible is the amount an individual must pay out of pocket before insurance coverage kicks in.
According to Ehealthinsurance.com, a 22-year-old nonsmoker living in New York City can be covered for hospital visits for just over $200 monthly under an HMO plan.
But as Wang discovered, such a plan is not a panacea, as even in the type of emergency it is designed for, insurance companies tend to reject as many claims as they can.
Columbia and Barnard Health Services officials acknowledged the problem of finding insurance post‑graduation, and said the University does its best to support alumni.
“We know that that’s a vulnerable time for people. We know that based on knowing our own students, and we know that based on national data,” said Samuel Seward , assistant vice president of Columbia Health Services. He noted that being unemployed even temporarily makes recent graduates more likely to fall out of the health care system in the long term.
“For a number of years, our graduates have had the option to continue with their [student] health insurance for up to 10 months, and that, overall, I believe, has been very well received,” he said, adding that last year’s recession prompted more students to take advantage of that option.
But Barnard Health Services Director Brenda Slade said the college recognizes that navigating the real‑world health care system takes more than just a few grace period months. During Senior Week each year, she said, she offers soon-to-be alumnae a series of tutorials on the system.
“I give two or three back‑to‑back sessions which are very well attended, just discussing the concepts of how to get a health care provider when you graduate, how to negotiate the world of health care, all the various scenarios. If you’re going to grad school, if you’re going to get a job, can you stay on your parents’ plan,” she said.
Even graduates like Elizabeth Case, BC ’09, lucky enough to land full-time jobs that provide insurance continue to struggle with the health care industry.
Case works for a nonprofit organization that specializes in urban planning and development and provides a basic health care package. But the plan only covers the lowest‑grade generic medications, and when she switched from brand‑name birth control to a higher‑dosage generic version, she suffered a severe allergic reaction. Now, while she is still covered by her employer’s HMO plan, her parents pay for her birth control separately.
“Trying to cover rent and food and pay for medication on top of that is kind of nuts,” she said. “But birth control isn’t something you can just stop taking.”
With affordable insurance hard to come by, many recent grads simply go without and hope their youth will guarantee good health.
“It’s important to have health insurance for emergency purposes, but I feel like dental and vision are places where I can make a judgment and save some money,” said Wang, who has neither now.
“I definitely take better care of myself, because going to the doctor isn’t the easiest thing to do right now,” Lopez added.
But as the Commonwealth Fund’s Nicholson noted, youth does not mean invincibility. Many young people struggle with binge drinking, weight problems, smoking, and sexually transmitted diseases, among other ailments.
“It’s really a time when young people should be seeing a primary care provider for preventative care,” Nicholson said.
Last year, Governor David Paterson proposed a statewide plan that would allow unmarried young adults to remain on their parents’ plans as dependents through age 29. The Affordable Health Care for America Act, passed by the House of Representatives on Nov. 7, would extend the allowable coverage age to 27. Before that can take effect, though, the Senate must pass its own bill, and in that process, no provision is fully safe.
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