Young adults are anxious about the state of the economy — and they have every reason to be. Over 40 percent of Americans under 30 say they’re “barely getting by” financially. They’re paying a larger share of their income on housing than their counterparts did a decade ago, and nearly a third have given up on ever owning a home.
Now, President Trump and congressional Republicans are coming for their health insurance too. When open enrollment opens on Nov. 1, millions of young adults will discover that their already difficult economic situations may get much worse in the new year. Premiums are set to skyrocket, roughly doubling on average, for the 24 million people enrolled in plans under the Affordable Care Act’s health insurance marketplaces. That is, unless Democrats get their way in the fight over the government shutdown, which hinges on health care access and affordability.
The pending premium spike is the result of congressional Republicans’ failure to extend health insurance tax credits, which expire this year. Add to that the $1 trillion Medicaid cut enacted by Republicans this past summer — the largest cut to that program in history — and experts estimate that some 16 million Americans may lose their insurance. Democrats have said that they won’t pass a bill to fund government operations until Republicans take action to stop this vast rollback of Americans’ health care coverage.
Young adults have a huge stake in this fight, because they stand to be disproportionately hurt by the exploding costs. With limited savings to fall back on and a job market that is particularly shaky for recent graduates, they have little margin to absorb the higher prices and may be more tempted to go without insurance. Nearly half of the roughly six million adults under 35 who are on Affordable Care Act marketplace plans are expected to drop them because of higher prices — a higher share than in any other age group.
Imagine a single 28-year-old making a salary of $39,000. She might be a content creator, a hairstylist, a child care provider — she’s already operating on a tight budget. This coming year, she’ll see her annual silver plan premium close to double, from about $1,500 to nearly $3,000. She’ll have to weigh whether to pay for that increase on an already overstretched budget or forfeit health insurance altogether.
When people can’t afford insurance, they’re less likely to seek treatment, leading to more expensive interventions later on, worsening chronic conditions, and mounting medical bills. Many end up going to an emergency room because they can’t get in to see a doctor. If you’ve been to an E.R. recently, or watched the hit medical drama “The Pitt,” you know the last thing this country can afford is to double down on emergency medicine being the default doctor for Americans.
The decision to lock an entire generation out of affordable coverage will have health and economic implications for decades to come. The health care system is far from perfect, but Medicaid is an undeniable lifeline for many young low-income Americans, and the tax credits under the Affordable Care Act gave millions more young people a chance at affordable insurance. Taking that away will subject struggling young people to even more intense financial stress. I fear the impact this will have on an entire generation’s trust in the institutions that are supposed to deliver stability, and more broadly in our government and democracy.
As prices rise and many young people are forced to forgo health insurance, it will have ripple effects on almost all people getting insurance through the Affordable Care Act marketplace. Because people who are healthy are more likely to drop out, premiums will increase for those who are still insured to cover the cost of care for people who are more likely to get sick and need expensive care.
It’s not just individuals covered by plans through the marketplace or Medicaid who will be affected. As people are less able to pay for care, rural hospitals will suffer losses. Already, at least three clinics in rural Virginia have closed their doors as a result of the Republican cut to Medicaid. Hundreds more rural hospitals and nursing homes could follow suit, jeopardizing the availability of lifesaving treatment and eliminating vital jobs in communities that are already unable to sustain stable employment amid industry shifts.
Congressional Republicans’ attack on health care betrays hardworking Americans. It sets us back in the fight to build a truly accessible and affordable health care system. People need better health care for less money, not the other way around.
Democrats understand this and have drawn a line in the sand demanding a reversal of the health care cuts and a permanent extension of the tax credits. A handful of Republicans have responded by proposing a Band-Aid solution: temporary extensions that would strategically delay the impact of the cuts until after the midterms to avoid any political blowback.
As insufficient as their proposal is, congressional Republicans’ push to delay the bill’s effects shows that they are starting to see the political fallout from their disastrous choices, which means there may be an opening to negotiate the government out of both a shutdown and a looming health care crisis. Americans deserve leaders who can deliver real answers on both.
Natalie Foster is the president of the Economic Security Project and author of “The Guarantee: Inside the Fight for America’s Next Economy.”
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