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Thursday, October 29, 2020

We're Young Adults. The Affordable Care Act Matters to Us, Too | Opinion

 We're medical students. Recent college graduates. Like many of our peers across the country, tuition and loans loom large over our heads. When it comes to health care, though, being "young adults" is our saving grace. That's because, like millions of Americans our age, we can stay on our parents' insurance until we turn 26.

As medical students on a path toward employment, we're the lucky ones. Many of our friends who recently graduated college found themselves on an unsuccessful job search in the middle of a pandemic. Without the provision of the Affordable Care Act (ACA) that lets young adults stay covered by their parents, our friends—some of whom have conditions like diabetes, arrhythmia and cancer—could have left school in debt, at risk and uninsured.

While many have rightly pointed out the broad stakes of the ACA—the Medicaid expansion, pre-existing condition protections and Medicare financing—less attention has been paid to what the ACA has meant for young adults. Prior to the ACA, we had the highest uninsured rate of any age group and lowest rate of employer-sponsored insurance. Young adults are less financially secure than older adults, and before the ACA, nearly half of uninsured young adults reported medical debt or difficulty paying medical bills.

Through the ACA, an estimated 2.3 million young adults aged 19 to 25 gained health care coverage between 2010 and 2013. According to surveys conducted by the Commonwealth Fund and the federal government, this increase in coverage was the largest among any age group.

Young adults have similarly benefited more than any other age group from the ACA's Medicaid expansion. Previously, most states limited Medicaid eligibility to those who were very low income, elderly, disabled, children, pregnant or had kids. Expanding eligibility to all adults with incomes less than or equal to 138 percent of the poverty level has allowed many more young adults, particularly young men, to receive coverage.

Even though young adults may seem to be a fit, low-risk group, the Medicaid expansion under the ACA has had huge health benefits. Low-income young adults received access to affordable health plans with increased services like mental health care, preventive care, prescription drugs and maternity care. Last year's highly publicized case of BYU-Idaho initially deeming Medicaid to not be school-acceptable insurance highlights the expansion's importance. Low-income BYU students already struggling to pay for rent—some of whom were married with children—could not afford the school's health insurance, let alone private coverage. Imagine if those students also didn't have expanded Medicaid as an option.

Young adults, while generally healthier, are also not immune to pre-existing condition discrimination. One in six young adults struggles with a chronic illness that might make it harder to purchase health care. Young adults aged 18 to 25, for instance, have the highest prevalence of mental illness or serious psychological disorders, and the isolation of the pandemic is only making matters worse. Access to affordable health coverage is essential for this population. Yet without the ACA, they could be excluded from coverage.

And during a pandemic where COVID-19 could be considered a pre-existing condition and young adults are experiencing job losses at rates far higher than other groups, these provisions are even more crucial. Though the impact of COVID-19 hasn't been as dire in younger populations as with older individuals, young people now make up the largest share of new infections and are far from invincible. The losses of a 19-year old Appalachian State student and 28-year old Houston OB-GYN resident due to COVID-19 complications illustrate this. Not to mention the apparent longer-term consequences COVID-19 can have on the brain, which could jeopardize any young person's future.

Our experience seeing patients during medical school has also brought home to us how important these ACA protections are for our generation. Last year, one early 20s patient came into the hospital with severe diabetic ketoacidosis, a life-threatening complication of diabetes that requires extremely costly treatments. Fortunately, that patient received the care they needed—because they had the insurance to cover it.

But in a world without the ACA—one that could soon exist after a November 10 Supreme Court challenge to the law supported by the Trump administration and Republican-led states—patients could be denied health coverage due to pre-existing conditions. They would not have the option of staying on their parent's coverage past high school or accessing expanded Medicaid.

That's why so much is at stake for our generation with the ACA. We've seen it with our classmates with pre-existing health conditions. We've seen it with young adult patients in unexpected ER visits. We've seen it in our own lives, as we've wondered what would happen if we got COVID-19 with severe complications. President Donald Trump's continued attacks on the ACA could put our generation's health in jeopardy.

Young adults: Our health care is on the line, too, this November.

Jesper Ke is a medical student at the University of Michigan.

Mathew Alexander is a medical student at Virginia Commonwealth University.

Suhas Gondi is an M.D. and MBA candidate at Harvard Medical School and Harvard Business School.

The views expressed in this article are the authors' own.

Here's help to apply for Affordable Care Act insurance


logo, company name: AxessPointe Community Health Centers has counselors who help consumers apply for the Affordable Care Act health insurance.© Submitted photo AxessPointe Community Health Centers has counselors who help consumers apply for the Affordable Care Act health insurance.

Help is available for people looking for Affordable Care Act health insurance coverage options through the federal Health Insurance Marketplace. 

Individual consultations

Due to the COVID-19 pandemic and restrictions, AxessPointe Community Health Centers this year cannot offer free group enrollment workshops. However, AxessPointe is offering individual consultations at three locations by appointment only and phone appointments with a Certified Application Counselor. 

More: Start here for answers on Affordable Care Act open enrollment

Information you need when you apply for coverage includes: your annual taxable household income, the names and addresses of all places of employment, ability to access a personal email account, the dates of birth and Social Security numbers of all household members, whether each person is applying for health coverage or not, and appropriate immigrant documents. Visit for additional information. 

Here is how to make an appointment: 

• To reach the Arlington office in Akron at 1400 S. Arlington St., call at 330-785-2044. 

• For the Barberton office at 390 Robinson Ave., call 330-564-2479. 

• For the Kent office at 143 Gougler Ave, call 330-564-2478. 

AxessPointe counselors also can help consumers sign up for Medicaid services year round. 

Certified application counselors

logo, company name: LifeCare Family Health & Dental in Canton has counselors who help consumers apply for the Affordable Care Act health insurance.© Submitted photo LifeCare Family Health & Dental in Canton has counselors who help consumers apply for the Affordable Care Act health insurance.

Two area agencies also have certified application counselors who can help any consumers apply for an ACA plan by appointment. Call Asian Services in Action Inc.’s Akron office at 330-535-3263. In Canton, call Lifecare Family Health and Dental Center at 330-454-2000, ext. 242 or 231.

logo, company name: Asian Services in Action Inc. (ASIA Inc.) has counselors who help consumers apply for Affordable Care Act health insurance plans.© Submitted photo Asian Services in Action Inc. (ASIA Inc.) has counselors who help consumers apply for Affordable Care Act health insurance plans.

More information

Ccnsumers also can call the federal marketplace at 800-318-2596 or go to to find local assistance. 

In addition, there may be some insurance brokers who can assist, but know that they are working on commission for private insurers. 

Beacon Journal staff reporter Betty Lin-Fisher can be reached at 330-996-3724 or Follow her @blinfisherABJ on Twitter or To see her most recent stories and columns, go to

This article originally appeared on Akron Beacon Journal: Here's help to apply for Affordable Care Act insurance

What’s new on this year's Affordable Care Act marketplace for Houston?


text: The 2021 Affordable Care Act exchange will bring a new insurance carrier to Houston while maintaining premium rates when open enrollment begins Nov. 1.© JOE BUGLEWICZ, STR / NYT

The 2021 Affordable Care Act exchange will bring a new insurance carrier to Houston while maintaining premium rates when open enrollment begins Nov. 1.

The 2021 Affordable Care Act exchange will bring a new insurance carrier to Houston while keeping most premiums around the same price as last year when open enrollment begins Sunday.


In Harris County, residents can choose from 84 insurance plans. More people are expected to enroll in insurance plans offered through the exchange this year as the pandemic forced layoffs and the loss of job-sponsored insurance.

Friday Health Plans, based in Alamosa, Colo., joins five other carriers on the open exchange: Ambetter, Blue Cross Blue Shield of Texas, Community Health Choice, Molina, and Oscar.

Sal Gentile, co-founder of Friday Health Plans, said their plans are designed for individuals like gig contractors like rideshare drivers who want coverage but are classified as independent contractors rather than employees

“We’ve filed and seen the rate comparisons to all the other filings, and we are confident that our prices will be the first or second lowest price in both the bronze and silver category, and among the cheapest in the gold category,” he said.

Bronze plans have lower monthly premium costs with high deductibles, while gold plans have higher monthly premiums with lower deductibles. Silver plans are a balance between the two.

Gentile said he expects to enroll as many as 20,000 customers in their plans in Houston because of their pricing.

Surrounding counties such Fort Bend and Montgomery counties don’t have Friday Health Plans as an option, but buyers can still compare and choose plans offered by several insurance carriers.

Prices aren’t very changing much from 2020 plans, insurers and analysts said. Statewide, the average price for the benchmark plan, the silver-level plan, has stayed flat.

That should be a relief for consumers in a year when many households are under financial stress because of the recession, said Stacey Pogue, a senior policy analyst at Every Texan, an Austin-based health policy think tank.

Consumers typically steer clear of the cheapest bronze plans, with most opting for silver plans that have moderate monthly premiums and deductibles. During open enrollment, though, many consumers revisit the marketplace to see if they can get a better deal on an insurance plan and save more money.

“Most people going into the marketplace are pretty price sensitive,” Pogue said. “People might be happy with their plan, but they’ll change year to year to keep that savings.”

Premium prices are down for the third year in a row nationwide, an 8 percent drop from 2018, according to the Centers for Medicare and Medicaid Services.

“You might think of it as the market stabilizing,” said Shara McClure, senior vice president of Texas health care delivery for Blue Cross and Blue Shield of Texas.

In the early years of the exchange, premium prices zigzagged across the charts as insurers struggled to project the demand was for individual insurance plans and adjust for rising health care costs. They spiked in 2016 and 2017, when health insurers such as Blue Cross Blue Shield of Texas and Community Health Choice imposed increases near 50 percent and larger insurers such as Aetna and Cigna pulled out of the Texas market, citing unsustainable losses while insuring people who were chronically sick.

Texas has the highest rate of uninsured residents in the nation, which has only risen higher with an estimated 1.2 million Texans losing employer-sponsored health coverage with their jobs during the pandemic-driven recession. As many as one in three residents could be without health coverage in 2020, according to the Kaiser Family Foundation, a San Francisco-based think tank.

Approximately 881,000 Texans qualified for subsidies for Affordable Care Act exchange plans during the pandemic because of the loss in income. If more households are eligible for reduced costs through subsidies, they’re more likely to purchase insurance plans.

Federal data shows that 1.1 million Texans purchased plans during open enrollment last year, about the same as the prior year.

More brokers and agents are licensed to help people enroll in 2021 plans, according to the Centers for Medicare and Medicaid Services. More than 40,000 people are registered to assist with enrolling customers in exchange plans, an increase of 5,300 agents from the year prior.

A challenge to the Affordable Care Act will be heard by the Supreme Court Nov. 10, but any decision, not expected before June, is unlikely to affect whether 2021 health insurance policies, Pogue said.

McClure, the Blue Cross and Blue Shield executive, said people are especially interested in purchasing health coverage this year because they’re anxious about high medical costs if they contract COVID-19.

“They could feel like their health risk is a little bit higher than it might be in a normal year,” McClure said. “We’re hopeful that more people who are eligible for coverage take advantage.”