More On Young, Healthy And Scraping By

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I posted a reader email yesterday from a 30something Brooklynite, TC, who is supportive of Obamacare but still can’t afford the premiums for health insurance on the exchange.

It prompted several emails from other readers with a range of reactions that basically fell into three categories: readers who could relate; older readers who, in almost a parental way, urged TC to reassess the financial risk of going without insurance; and readers who, if I can freely summarize, had little patience for underemployed hipster financial predicaments.

Here’s a sampling:

From the “me, too” category, TPM Reader GS:

Hey, I’ve been a close follower of TPM for a long time, and I can’t tell you how good it made me feel to read TC‘s letter about being a young adult unable to afford the new plans available through the ACA.

I had been purchasing one of those bare bones, catastrophic plans in order to placate worried parents. The few times I went to the doctor it paid for next to nothing and certainly didn’t help with any prescriptions I needed. As a big Obama supporter the past elections, I was actually excited to enroll and help support the ACA’s enrollment numbers. I tried enrolling within the first few days of the website’s rollout, and continued logging into the site for months as they were fixing it. Imagine my disappointment to find myself in the exact same predicament as TC.

I’m in the same boat, living in NYC, 30 years old, working in a restaurant, paying a ton for rent, utilities and expenses while also not qualifying for any financial assistance. It kills me to stay on my cheaper, catastrophic plan, but I have no other option. I just can’t afford the $310 premiums.

There are a huge number of folks in my same situation, working jobs in the service industry without access to real healthcare and making just enough for them to not be able to qualify for assistance. Couple that with the crippling cost of higher education and a lack of viable career options, and what are your real options?

When I finally got through on the website and saw what my options were, I felt terrible. It’s bad enough knowing your financial situation is tenuous in general, but this just felt like a kick in the gut.

From those urging TC to reassess his risk, TPM Reader MH:

I know how TPM reader TC feels–I went without insurance for a few years after college (pre-Obamacare) and it’s easy to feel like it’s cheaper to pay for the occasional medical care out of pocket than shell out for insurance every year.

But.

Anyone who still has their appendix has a $30,000 ticking time bomb in their abdomen. There are no risk factors for appendicitis, no warning signs, it can strike at any age, and the only treatment is an appendectomy. When I had mine out a few years ago at the ripe old age of 29, the retail (pre-insurance discount) price tag was just under $30,000. I had great, employer-provided insurance, so I paid $50 for the ER and $400 for the hospital stay. But had it struck a few years earlier, when I was an unpaid, uninsured intern, I would have been bankrupted. Before the age of 30.

And there are dozens of things like this, that are independent of age, health, or lifestyle. You can obey every traffic law and never jaywalk a day in your life, and a bad driver can put you in the hospital for months.

That’s why you carry insurance. Yes, perhaps it’s cheaper to pay for the occasional doctor’s visit out of pocket–but real health insurance is what stands between each of us and bankruptcy.

TPM Reader MC:

Regarding the post from TC explaining why he/she cannot afford health insurance, my thought is that a person cannot afford NOT to have insurance. I have been self-employed for years and have paid very high premiums to insure myself and my family. My husband is also self-employed but I covered him under my policy because I found a group I could belong to who offered insurance to group members. Even though I had insurance, I knew that I was only one serious illness or accident away from financial devastation. If I were seriously ill, my insurer might rescind coverage because they could. At least now they cannot do this.

When my children started their work lives, their employers often did not offer health insurance either because the job was not full time, or insurance was only offered after you had worked at the company for a period of time. So I paid their premiums so that they would have some kind of insurance. Again, I knew they were only one accident or devastating illness away from my complete financial devastation. What parent would allow their child, no matter how old, to have to forego medical care because they had no insurance. If the parent had any savings at all, they would use it all to help their child.

What I would say to TC is it is short-sighted not to find some way, if at all possible, to pay for insurance. If TC’s parents or other family can provide help,TC should let them. Families are all in this together, no matter how old the children are. Health insurance should be a top household budget priority, after food and shelter. I am thrilled that we now have the ACA and after the fits and starts of its rollout, I hope we will see it grow in quality. It is one of the single most important laws ever passed.

When my children started their work lives, their employers often did not offer health insurance either because the job was not full time, or insurance was only offered after you had worked at the company for a period of time. So I paid their premiums so that they would have some kind of insurance. Again, I knew they were only one accident or devastating illness away from my complete financial devastation. What parent would allow their child, no matter how old, to have to forego medical care because they had no insurance. If the parent had any savings at all, they would use it all to help their child.

What I would say to TC is it is short-sighted not to find some way, if at all possible, to pay for insurance. If TC’s parents or other family can provide help,TC should let them. Families are all in this together, no matter how old the children are. Health insurance should be a top household budget priority, after food and shelter. I am thrilled that we now have the ACA and after the fits and starts of its rollout, I hope we will see it grow in quality. It is one of the single most important laws ever passed.

And from the give me an effing break category, TPM Reader RM:

Was the TC story a joke?

What I’m supposed to feel bad that some 32 year old has made a series of wrong and terrible decisions and now can’t afford $308/month? Oh no! He wouldn’t be able to go to movies!? The horror!

He’s right, we should massively overhaul our entire system yet again so that he can have other Americans cover his tab allowing him to still make it to the opening of this weekend’s blockbuster (which he can pay for with his credit card). I’d love to hear what the other “etc” entailed.

It’s his fault he’s buried in credit card debt. It’s his fault he took out loans to get a Masters degree and then work in a restaurant. It’s his choice to live in NYC with the substantially higher cost of living… If you’re “scraping by” why have a car and car insurance if you live in NYC?! The public transportation (which he’s paying for as well) there is more than adequate for daily life.

I’m all for helping the poor to get coverage, but this story was simply a whiny 32 year old who has made dumb decisions in his life and now wants everyone else to foot the bill for him.

TPM Reader JZ:

I’m not sure what the take-home message of the post by David Kurtz “Young, Healthy And Scraping By” is supposed to be, other than that young adults have misplace priorities, poor money management skills, and an insufficient appreciation of the value of health insurance.

It is incredible that the reader pays roughly 25% of his or her income for debt but balks at paying 7% for health insurance. It is unfortunate that the reader is not putting the master’s degree to good use, but $55,000 is a good salary. Many people are doing worse.

This is not a problem with Obamacare. Even if the premium were half as much, the reader would still have difficulty with those spending priorities. Get a roommate or cut some expenses, and then pay down that debt.

This shows why the individual mandate and penalties are needed.

I’m in a situation similar to that of the reader: I’m a 33-year-old American, I earn 6,000,000 yen (about $57,000), I live near Tokyo (high cost of living), and I pay about $300 dollars for my health insurance from the Japanese government. But I have no debt. I used to have about $30,000 in credit card and student loan debt that I worked to pay off (when I was making half as much money).

When I came to Japan, I was amazed by the easy access to health insurance, which is similar to Obamacare in terms of cost and level of service. Now that Obamacare is available, it would be a shame for people my age not to take advantage of it.

TPM Reader DC:

Mandatory insurance purchase is not unlike other regulations that prevent people from cutting corners; TC may have been living beyond his means, and either needs to spend less or earn more.

The whole point of many regulations is to prevent people from cutting risk corners in a race to the bottom — truck drivers DO need to take breaks, and if these were not mandated, those who need the least sleep (or more likely, are the most overconfident) will force a lower standard for everyone else.

Same for health insurance — if people scraping by can pay a higher rent by skipping health insurance, they might do that, and it drives up the rent for everyone else, including the responsible people who do buy health insurance. If a bank can offer an apparently higher interest rate to depositors by relaxing loan or capital cushion standards, they’ll do that, too, and if their competitors don’t follow suit, the competitors will lose depositors.

Interfering with the market? You betcha. If not for laws and regulations, the market would grind up humans for dog food, if there was a buck to be made doing that.

TPM Reader EO:

Never written in before, but I call bullshit on TC.

He has plenty of money to afford health insurance, but doesn’t think he needs insurance, and obviously doesn’t care enough about making the program successful to sign up.

Really it’s no better than a Tea Party response – I don’t need no stinking health insurance, and if something does happen I’ll just go to the emergencyroom.

With friends like that, the opponents of Obamacare won’t have to do much at all.

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