Before the passage of the Affordable Care Act, or ACA, young adults comprised the most uninsured age group in the country. Between January and March 2010, almost one-third of young people between the ages of 18 and 24 were uninsured—around double the national average in the same year. Barriers to insurance—such as lack of protections for pre-existing conditions and unfair insurance policies that can increase premiums or terminate plans if a person becomes sick—affected all age groups before the ACA’s implementation. But young people also faced additional factors that limited their access to health care and lowered their rates of insurance.
Prior to the ACA, young adults generally could not stay on their parents’ plans in their early 20s. Instead, young people who received health coverage through their parents’ plan, Medicaid, or the Children’s Health Insurance Program, or CHIP, typically aged out of their insurance plans at 19. As discussed in a 2013 Center for American Progress report, “How the Affordable Care Act Helps Young Adults,” the lack of affordable, comprehensive health insurance plans created another major barrier to accessing health care. In addition to prohibitive costs, young people were—and still are—less likely to get health insurance through their employers.
Once Congress passed the ACA in March 2010, however, things began to change. By September 2011, almost a year after the policy allowing children to stay on their parents’ health plan took effect, the number of young adults between ages 19 and 25 who had health insurance jumped more than 10 percentage points to 74.8 percent. The ACA gave millions of young people the opportunity to keep health care coverage through their parents’ plan. And after the ACA’s marketplaces opened in late 2013, millions of young adults were able to sign up for their own plans, with many receiving financial assistance to help them afford coverage. Policies such as this—as well as protection from discrimination based on pre-existing conditions and the prevention of lifetime coverage limits—have helped young people access and maintain their insurance. Standards including no-copay birth control, mental health services, screenings for sexually transmitted infections, and breastfeeding support have helped make health insurance work for young people.
The release of the 2014 Current Population Survey offers insight into the ACA’s impact today, especially as contrasted with 2013 data and especially when comparing the data for Millennials. In general, Millennials are defined as the generation born roughly between 1980 and 2000, and in this column, we categorize Millennial adults are those who were ages 18 to 34 in 2014.
Uninsured rates fall across the United States
According to the new data, the national rate of uninsured people fell from 13.3 percent to 10.4 percent from 2013 to 2014, with 8.8 million people gaining health insurance.
The data indicate especially momentous progress in increasing health insurance access for young people across the United States. The uninsured rate for 18- to 34-year-olds in 2014 was 17 percent, down more than 5 percentage points from the 2013 rate of 22 percent. From 2013 to 2014, 3.6 million Millennial adults gained coverage.
From 2013 to 2014, the uninsured rate decreased for every single age group. The peak uninsured age is 26—the age at which young people are no longer eligible to stay on their parents’ plans. Almost one-third of 26-year-olds still lacked health insurance coverage in 2014.
Uninsured rates fell significantly for Millennials of color but remain high
In addition to the drops in the uninsured rates across all age groups, 2014 also saw significant decreases in uninsured rates across all major racial and ethnic groups. The changes in uninsured rates for black and Hispanic Millennial adults were particularly striking: The uninsured rate for Hispanic Millennial adults fell by 7.3 percentage points, and the uninsured rate for black Millennial adults fell by 6.1 percentage points in 2014.
While the 2014 numbers are extremely encouraging nationwide, disparities persist along racial and ethnic lines. Hispanic Millennial adults had an extremely high uninsured rate in 2014 at 28.5 percent, significantly higher than the Millennial adult rate and almost triple the national rate. Both black Millennial adults and Hispanic people of all ages were uninsured at almost double the national rate, at 20.7 percent and 19.9 percent, respectively.
The work that remains
Millennials are striving to create better futures for themselves as students, parents, and employees, but their access to health care continues to lag behind other age groups. This is especially the case for young people of color. One big driver of these uninsured rates is the refusal of governors and lawmakers in 20 states to expand Medicaid. Medicaid expansion has benefited millions of low-income people of all ages across the country, but it is particularly important for Millennials, who as a group continue to face barriers to success.
Today, more than 70 percent of minimum wage workers are Millennials between ages 16 and 34, and the median income of 18- to 34-year-olds today has fallen by thousands of dollars compared with previous generations at the same age when adjusted for inflation. Even as the national unemployment rate gradually returns to prerecession levels, youth unemployment rates remain high—especially for Millennials of color—and more Millennials live in poverty today than previous generations did at the same age.
The Census Bureau data released this week show that the ACA has made great strides in increasing access to high-quality, affordable health care for young people across the country. Federal and state marketplaces, along with Medicaid expansions, have provided many young people with new options. However, more must be done: The insurance rate for young people—notably for 26 year olds—continues to lag behind the national rate. In addition, politicians’ refusal to expand Medicaid in 20 states means that too many people are still struggling to access basic health care. As members of the Millennial generation continue to work to support themselves and their loved ones, access to comprehensive, affordable health care is a key part of obtaining economic stability now and in years to come.
Sarah Audelo is the Policy Director for Generation Progress. Sunny Frothingham is a Policy Advocate for Generation Progress.