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As health-care legislation advances through Congress, the young adults who were so vital to President Obama's election are emerging as a significant beneficiary of his top domestic priority, but they are also likely to play a major role in funding any reform. ...In part, young adults are uninsured because they are less likely to work for employers who offer coverage; they may not qualify for public programs such as Medicaid; and even the skimpiest private insurance plans may be too expensive alongside hefty student loan payments and credit card debt. But some young people -- nicknamed the "young invincibles" -- are also likelier than other Americans to assume that they won't need health insurance or to decide that they'd rather spend their money on other things. To discourage that attitude, the Finance Committee bill would fine individuals who do not purchase coverage. An early draft of the proposal set the penalty at $750 or $950 per year for single people, depending on income. But according to various insurance experts, even the least expensive plan under the bill could cost more than $100 per month, making it cheaper for people to pay the fine than to buy insurance. All the bills seek to blunt the additional cost to young adults, mainly through subsidies, but it is not clear what effect that would have. "The primary question is what the premium is and what people get for that," said Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution and a former senior Bush administration official. Adding preventative care to a catastrophic policy makes the Finance Committee bill's bare-bones coverage more appealing, McClellan noted. But for many young adults, health care will become a significant new expense. "It's important for people to know what they're getting into," he said. But it's also essential that young, healthy people participate, said Linda J. Blumberg, a health-care expert at the Urban Institute, because the requirement that people have insurance "is really a mechanism for financing health-care reform." The more people steered into the system through such a mandate, Blumberg and others explained, the lower the total subsidies that the government must provide to keep insurance affordable. But if young people slip through the cracks -- or if Congress, facing political pressure, provides generous exemptions from the mandate -- then the government and people who buy coverage will face higher costs....
