To make the math work — and to cover the medical bills of older, sicker enrollees — insurers have often had to raise rates for young adults. They have also had to cancel some of the plans they offer younger subscribers, which tend to have lower premiums but less-robust benefit packages. That means that, in the exchanges, young shoppers might see much higher sticker prices and experience what the news media has called "rate shock."
However, many young adults won't have to pay the full price. Instead, most will qualify either for Medicaid — the public health program that serves low-income Americans — or for tax subsidies to help buy coverage. The nonprofit Families USA, which supports the health-care law, estimates that about 9.3 million people between 18 and 34 will qualify for a subsidy to purchase health insurance. Between these subsidies and Medicaid, the government estimates that about four in 10 young Americans will pay a monthly premium of less than $100 for a plan under the federal law.
Emily Wright, a 28-year-old student in Tennessee who had previously been without health insurance because of a preexisting condition, found a top-tier plan that cost $244 per month. Because she qualifies for a federal subsidy of $119, she is paying only $125 each month toward that premium. Since Tennessee isn't expanding Medicaid, she worried that she might not receive financial help: "I was nervous about what I was going to be paying, but it was actually a great deal."
5. Young people aren't signing up for health care yet.
While they haven't made up the majority of the health-care law's participants so far, young adults do account for some enrollment. In states that have released demographic information, such as Washington and California, young adults were about 20 percent of the first month's enrollment. In California, the state exchange had 6,924 people between ages 18 and 34 sign up for coverage, accounting for almost 24 percent of all enrollments in October.