Doctors: Uninsured young adults gambling long-term health

SEATTLE -- When Chelsea Teigen of Olympia was 20 years old she left a modest-paying job with benefits for a position with greater pay but no medical insurance.

While uninsured, Teigen noticed a bump on her shoulder. Over two years the bump slowly grew, but Teigen didn't seek medical attention because she could not afford it. After a teacher gave her cash to visit a walk-in clinic, the young mother learned she had ewing sarcoma, a type of bone cancer.

It wasn't until four months into her cancer treatment that Teigen qualified for Medicaid.

"My bills had reached around $150,000 by that point," she said. "I had no other choice but to file bankruptcy. I would get a single bill for $25,000 and just laugh because it was such an unrealistic amount of money and I had given up on ever being able to pay it."

Young adults without medical insurance are often warned a catastrophic accident or illness could ruin them financially. But, local doctors say living without insurance could hurt young adult's long-term health, as well.

In 2010, nearly half of Washington's uninsured adults were 18 to 34 years old, making young adults the least likely age group to have insurance, according to the Washington State Budget & Policy Center.

Since the Affordable Care Act began allowing young adults to stay on their parents' health care plan through age 26, the number of uninsured adults between 19 and 25 has dropped from 48 percent to 41 percent. But, local agencies say this will still be one of the most challenging demographics to enroll in health care coverage before reform takes effect in January.

"They feel like nothing happens to them," said Daphne Pie of Seattle and King County Public Health. "They ask, 'Why do I have to pay money for something I may not use?'"

Dr. Kim Pittenger of Virgina Mason said young adults shouldn't just have catastrophic coverage, they need primary care. He said 20-somethings who receive basic services, such as vaccinations, cholesterol profiles, heart disease assessments, and blood pressure and mental health evaluations, have better long-term health.

"The diseases that cause premature death are cooking in our 20s," he said.

For women, Dr. Peter McGough, a professor of family medicine at the University of Washington, said it is important to begin gynecologic care as a young adult for family planning and to prevent sexually transmitted infections.

"Gynecologic health without insurance tends to start at the first prenatal visit," McGough said.

Planned Parenthood's "Take Charge" program offers free birth control, emergency contraception and screenings for some sexually transmitted infections to uninsured Washington residents. McGough commends the program, but said women who are on Medicare will have access to recommended services that Take Charge does not cover.

"Having a place that becomes a go-to for acute health needs is important," McGough said. "They're going to get the chance at a healthier life that aligns with their family planning choices."

For young men, McGough said a primary care doctor can assess risky behaviors like smoking, drinking and driving and unprotected sex.

"It's about encouraging a healthy lifestyle," McGough said. "Without insurance, you're playing a very dangerous lottery game. If you have a serious injury, you're broke for life. "

Pittenger is concerned young adults who are overweight or obese have a greater risk of developing serious health complications later in life if they do not learn to manage their weight in their 20s.

Beginning Jan. 1, 2014, the Affordable Care Act will require all U.S. Citizens over a certain income level to have health insurance or pay a penalty.

Expansion of the Medicaid Program will make 180,000 King County residents newly eligible for coverage. All Washington residents will be invited to use the Washington Healthplanfinder to find the best coverage option for them beginning Oct. 1.

Michael Marchand, director of the Washington Health Benefit Exchange, said the mission to convince young adults that there is value in health insurance keeps him up at night.

"We have to change the story that's always been told about health insurance," Marchand said. "All it takes is one unfortunate rendezvous with chance and then you're really wishing you had that coverage."