The young and healthy don’t generally believe they need health care coverage and that outlook could pose a major problem for Republicans who await a delayed vote on a replacement for the Affordable Care Act. Insurers need young and healthy enrollees to buy insurance because they keep premiums down for everyone. The current law attempts to do that by mandating that everyone get coverage. The Republican plan replaces that mandate with penalties for those who let coverage lapse and aims to entice young adults by allowing insurance companies to sell bare-bones coverage that could be cheaper, but cheap isn’t free and young adults worry that opening the door to these bare-bones plans will make the more comprehensive coverage they know now too expensive or even unavailable. Language is still being nailed down in the retooled bill, but it includes a proposal from conservative Sen. Ted Cruz, R-Texas, which would let insurers sell plans with minimal coverage, as long as they also sell policies that meet strict coverage requirements set by the Obama-era health care law. Insurers could deny the slimmer coverage to people with pre-existing conditions or charge them more. To encourage continuous coverage, the GOP plan installs a six-month waiting period for anyone with a two-month gap in coverage. The skimpy policies wouldn’t qualify as continuous coverage. Other features of the proposal aimed at young adults include allowing them to stay on their parents’ insurance until they turn 26, as they can now, and shifting costs to older enrollees. Current law restricts how much insurers can charge for insurance based on age. “Obamacare” limits the ratio to 3-to-1, meaning a 50-year-old can be charged only three times as much as a 20-year-old. The Republican plan shifts that ratio to 5-to-1. More flexible pricing could attract young adults, the Congressional Budget Office said in a review of a previous draft of the Senate plan. But other provisions, including cuts to Medicaid, would result in 22 million people losing insurance over the next decade. All ages and income levels would have higher uninsured rates. For low-income young adults, CBO said, the uninsured rate would double. A CBO analysis was expected Monday but has been postponed, according to the Senate Budget Committee. Senate Majority Leader Mitch McConnell announced late Saturday he was delaying the vote on the bill while Sen. John McCain recovers from surgery. McCain is a much needed “yes” vote on the senate bill. Young Americans, ages 18-34, remain more likely to be uninsured than older age groups, but the rate of uninsured young Americans dropped under “Obamacare” to 16 percent from 29 percent.
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