Summer/Fall 2014
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“Young Invincibles” and Health Insurance: Strategies to Get Young Adults Covered

By Sinsi Hernández-Cancio, Director of Health Equality, Families USA, a lawyer, health policy analyst, and mom, has nearly 20 years of experience fighting for equal rights for women and families of color. She is the Director of Health Equity at Families USA, a nonpartisan, nonprofit organization that advocates for better access to high-quality health care for all.
“Young Invincibles” and Health Insurance: Strategies to Get Young Adults Covered

Good health is important for building a strong future. But when young people are just starting life as adults, health insurance may be the last thing on their minds. They believe they are “young invincibles.”

Young invincibles are adults ages 18-34 who are supposedly not interested in buying health insurance because they believe they will not need medical care. Enrolling this demographic has been a high priority because it is considered essential to the success of marketplace coverage.

Conventional wisdom said young adults would not be interested in enrolling. But conventional wisdom was wrong.  

Young Adults Need and Want Health Insurance

The uninsured rate for young adults is 30 percent, the highest of any age group.1 One reason is that they are least likely to be offered job-based insurance, the primary way people get coverage.2

The Affordable Care Act provision allowing young adults to stay on a parent’s health plan until age 26 has helped approximately 3.3 million young adults secure coverage, including more than 1.5 million young adults of color. But that helps only those whose parents have insurance.3

Data show that young adults—especially those of color—need insurance. Without health insurance, young adults are less likely to seek preventive care and more likely to postpone doctor visits due to cost.4 One in six young adults has a chronic disease.5 African Americans ages 20-34 are more likely than other racial or ethnic groups to die from diabetes and heart disease, most often preventable chronic conditions.6,7

Fortunately, young adults are not as unconcerned about health insurance as believed. According to recent polling by the Kaiser Family Foundation, 87% of young adults said it was “very important” to have health insurance, and 68% said health insurance was worth the cost.8 Statistics from the first open enrollment period confirm this: Of the 8 million people who enrolled, 2.2 million (28%) were adults ages 18-34.9

Targeted Outreach and Enrollment Strategies

The next open enrollment period is November 15, 2014 to February 15, 2015. As organizations plan for outreach and enrollment, many are looking for ways to reach young adults.

During the first enrollment period, organizations like Enroll America, Young Invincibles, AARP, and the American College Health Association developed several campaigns and resources targeting young adults. Two strategies made those efforts successful: meeting them where they are, and using trusted messengers.

Meeting young people where they are

Engaging Them Online
Social media is important for reaching young adults, especially young adults of color.

  • Of people ages 18-29, 84% use Facebook, and 31% use Twitter.10,11
  • African Americans and Latinos generally use social media more than non-Hispanic whites.12
  • Ninety-eight percent of Americans have cellphones, and cell owners ages 18-24 exchange an average of 109.5 texts daily.13   
  • Fifty-two percent of smartphone users find health information using their devices;14 38% of Latinos and 35% of African Americans do so as well.

Campaigns used Twitter chats and Google hangouts, and some enlisted celebrities with thousands of followers, like John Legend, to spread enrollment messages.15 Young Invincibles developed toolkits explaining how to use social media to disseminate information about health insurance and enrollment.16

Engaging Them in Person
Face-to-face communication is even more important than online methods. The key is to reach young adults where they work, shop, pray, and play:

  • colleges, community colleges
  • malls, grocery stores, drug stores
  • churches
  • nightclubs, sports venues

Maryland created ad campaigns for use in grocery stores and CVS pharmacies.17 Enroll America is planning a “rap battle” where performers will rap about health insurance.18

Using trusted messengers

Trusted sources for young adults may be different than those for older adults.

  • Mothers and grandmothers:19 Maternal figures are important motivators for young adults. Some campaigns reached out to mothers and grandmothers to tell their children and grandchildren to get covered: AARP created e-cards for parents to send to their adult children.20
  • Faith leaders: Churches are central to many Black communities. Organizations like Enroll America worked with faith leaders to spread the “get covered” message and host enrollment events.21
  • Greek organizations: Black fraternities and sororities have extensive networks, and some have health and wellness missions. Enroll America teamed up with fraternities and sororities to train volunteers to canvas in underserved neighborhoods and hold enrollment events at local churches.22

Conclusion

As community leaders develop their outreach and enrollment campaigns, reaching young adults may seem daunting. But organizations can use these strategies to get young adults of color to enroll in coverage, protecting their health and their futures.

Asia Young, FamiliesUSA Health Equity Intern, contributed to this article.


  1. Centers for Medicare & Medicaid Services, Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses. Retrieved from: http://www.cms.gov/CCIIO/Resources/Files/adult_child_fact_sheet.html
  2. Ibid.
  3. U.S Department of Health and Human Services, Report Shows Affordable Care Act Has Expanded Insurance Coverage among Young Adults of All Races and Ethnicities, July 2012. Retrieved from: http://aspe.hhs.gov/health/reports/2012/YoungAdultsbyGroup/ib.shtml
  4. Sarah R. Collins, The Commonwealth Fund, Covering Young Adults under the Affordable Care Act: The Importance of Outreach and Medicaid Expansion, August 2013. Retrieved from: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2013/Aug/1701_Collins_covering_young_adults_tracking_brief_final_v4.pdf
  5. Centers for Medicare & Medicaid Services, op. cit.
  6. CDC, Leading Causes of Death in Females, 2010. Retrieved from: http://www.cdc.gov/women/lcod/
  7. CDC, Leading Causes of Death in Males, 2010. Retrieved from: http://www.cdc.gov/men/lcod
  8. Kaiser Family Foundation, Kaiser Health Tracking Poll, June 2013. Retrieved from: http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-june-2013/
  9. U.S. Department of Health and Human Services, Health Insurance Marketplace: Summary Enrollment Report for the Initial Annual Open Enrollment Period, May 1, 2014. 
  10. Pew Research Internet Project, Facebook Users, January 8, 2014. Retrieved from: http://www.pewinternet.org/2014/01/08/social-media-update-2013/facebook-users/
  11. Pew Research Internet Project, Twitter Users, January 8, 2014. Retrieved from: http://www.pewinternet.org/2014/01/08/social-media-update-2013/facebook-users/
  12. Pew Research Internet Project, Facebook Users, op. cit.
  13. Aaron Smith, Pew Research Internet Project, Americans and Text Messaging, September 19, 2011. Retrieved from: http://www.pewinternet.org/2011/09/19/americans-and-text-messaging/
  14. Susannah Fox and Maeve Duggan, Pew Research Internet Project, Main Findings, November 8, 2012. Retrieved from: http://www.pewinternet.org/2012/11/08/main-findings-6/
  15. Natalie Villacorta, Politico, “Celebrities Tweet Obamacare Deadline,” March 31, 2014. Retrieved from: http://www.politico.com/story/2014/03/celebrities-tweet-obamacare-deadline-105209.html
  16. Young Invincibles website: http://health.younginvincibles.org/advocates/
  17. Maryland Department of Health and Mental Hygiene, Lt. Governor Brown and Maryland Health Connection Unveil Advertising and Outreach Campaign, September 3, 2013. Retrieved from: http://dhmh.maryland.gov/newsroom1/Pages/LT--GOVERNOR-BROWN-AND-MARYLAND-HEALTH-CONNECTION-UNVEIL-ADVERTISING-AND-OUTREACH-CAMPAIGN-.aspx
  18. Alex Dombronovith, Georgia State Communications Director, Enroll America, August, 21, 2014.
  19. Kathleen Sebelius, A Mom’s Trusted Voice on Health Insurance, August 6, 2013. Retrieved from: http://www.hhs.gov/healthcare/facts/blog/2013/08/womens-health.html
  20. AARP, Nudge Your Kid about Getting Health Insurance. Retrieved from: http://www.aarp.org/ws/affordable-care-act/mom-means-it/
  21. Alex Dombronovith, op. cit.
  22. Ibid.
Sinsi Hernández-Cancio

Director of Health Equality, Families USA, a lawyer, health policy analyst, and mom, has nearly 20 years of experience fighting for equal rights for women and families of color. She is the Director of Health Equity at Families USA, a nonpartisan, nonprofit organization that advocates for better access to high-quality health care for all.

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