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Catherine Rampell, from the New York Times blog Economix, suggests an alternative to the conventional wisdom that youth aren't insured (and don't care about reform) due to their invincibility.

Rampell constructs her argument using some Gallup data released last week. First, she confronts the idea that young people, assumed to be healthier than the rest of the population, would rather risk not buying health insurance, thus leading to higher costs for the rest of the pool. In fact, Rampell finds that young people are actually less willing to take risks than you might think:

Three-quarters of those 18-29 year-olds describing themselves as healthy still purchased health insurance. As Rampell explains, one can dig deeper into this data, inquiring about variables like income. Rampell does that and finds something.

Perhaps people who are likely to have health insurance are also likely to be healthy for an independent reason: It costs money to buy health insurance, and it costs money to maintain a healthy lifestyle. In other words, perhaps it is money, not perceived risk of getting sick, that determines whether young people get insurance.

As it turns out, people who can afford health insurance are much, much more likely to get it:

Among young adults, 86 percent of those in the top third of the income distribution (people earning $48,000 or more annually) have health insurance. In the middle third (those earning between $24,000 and $48,000), 72 percent have health insurance. And in the bottom third (those making less than $24,000), just 58 percent are on a health plan.

It appears to be affordability, not recklessness (or even rational cost-benefit analysis of health risk), that is driving young people away from insurance policies.

Though reporters and pundits might think something is true, that doesn't mean there aren't other unseen or unmentioned possibilities or factors affecting the phenomenon. Thanks to Catherine Rampell for digging deeper.

An interesting blog post at Newsweek's "The Gaggle":

The other issue, I think, is the way health insurance has been sold and positioned. In general, we talk about the outcome of health care reform in two ways: the micro impact on individual citizens and the macro impact on health care costs. Neither has struck a cord with Millenials [sic]. Like I said, the individual impact strikes us as unimpressive. The large-scale economic outcomes take a lot of effort to understand. They seem distant, probably to Millenials [sic] and the rest of the population, and easy to lose sight of in a Twitter-size news cycle.

Instead, the more attractive part of health insurance for Millennials, these poll numbers indicate, is the moral underpinnings of the bill: that all Americans ought to have access to insurance, that this is our responsibility as a nation. While 47 percent of Millennials generally support health care reform, 70 percent support the idea that all Americans should have access to affordable health insurance, the highest number for any demographic. Maybe we’re just young and idealistic, maybe we have genuinely different viewpoints than our parents; either way, that provision really strikes a cord with younger Americans. But the bill has not been sold that way--if it had, perhaps more Millennials would strongly support health care reform instead of the kind of, sort of support we see now.

Yes, the expertise gap is tough for us to navigate. But I think what's worse for youth engagement is the heavy presence of traditional Washington behavior. Untelevised hearings. Deals behind closed doors. Inaccessible jargon. A lack of political courage. All of these elements and more preclude young people from focusing on the moral principle at stake.

We live in the United States -- all of us should should have access to affordable health insurance. But when the discussion is misrepresented, shrouded in Washington-speak and timidity, we lose that right to health care and we (young people) understandably lose patience with the process.

Don't you wish we could just all jump into a bus and go canvas Connecticut?

Newsweek is reporting this morning that the Senate's version of the Health Insurance Reform bill will feature a restoration of funding for abstinence education.

"Their provision would restore a program called Title V, which, since the Welfare Reform Act of 1996, has allocated a yearly $50 million in grants to abstinence-only education programs. Obama let the program lapse in June, leaving some abstinence-only groups in dire straits. So in September, Sen. Orrin Hatch offered an amendment to restore Title V via heath-care reform, which (much to the outrage of liberal groups) just squeaked through the Senate Finance Committee with a 12–11 vote. A similar amendment, offered in the House by Rep. Terry Lee from Nebraska, died in committee.

The American Medical Association reported this summer that Abstinence Only Education programs not only don't work, but they could also be the cause of the spike in teen birth rates in 2006.

"This report stated that these abstinence programs resulted in "no delay of initiating sexual activity, no reduction in the number of sexual partners and no increase in abstinence," according to Stuart Gitlow, MD. . .

"The AMA believes that federal funding should support sex education programs, which include condom use, abstinence and other methods of contraception."

Its quite simply nonsense for federal funds to be given to programs we have proven don't work and can result in the increase in sexually transmitted diseases to our nation's youth. Last year, ABC News reported that 1 in 4 teen girls now has an STD.

When will conservative US Senate members put right-wing ideology aside and allow young people to have the facts about protecting themselves and their own health?

Jose Antonio Vargas has a piece on the Huffington Post asking what happened to all of the young people that turned out for Obama. He also asks where too is the mainstream media

"the same MSM that declared 2008 as "The Year of the Youth Vote" -- in covering how young people are impacted by the health care debate, which has dominated the news for months? (Studies show that a quarter of Americans ages 25 to 34 don't have health insurance, while about a third of Americans ages 21 to 24 live without it -- more than any other age group."

Vargas says this is in part due to the high unemployment among young people and that many employers don't offer health insurance.

"Where is the Team Obama that adeptly leveraged the enthusiasm of its digitally-plugged young troops, who scheduled rallies on Facebook, passed YouTube videos around their network and sent text messages reminding their friends to vote? Speaking last month at George Washington University, just a few blocks from the White House, Obama's campaign manager David Plouffe told the college crowd: "Your generation won the election. . .Obama simply wouldn't have been the nominee without you."

He goes on to quote our friend Tobin Van Ostern who created Students for Barack Obama but who is now working with Campus Progress

"But, as far as I can tell, engaging young people hasn't been a top priority for the OFA, DNC and the White House."

Sad but true. Vargas talks about who is knocking doors for OFA and who is doing the work for the DNC but the long and short is that the work done by the campaign to do outreach to young voters, on campus, online, in their communities isn't even half of what they did during the campaign.

We were lucky to have a representative from the Treasury Department speak at the 80 Million Strong Conference and had Interior Secretary Ken Salazar talk about the outreach he is doing to young people to encourage them to get more involved in our state and national parks. Beyond that there is very little outreach to young people, particularly considering that young people were such a large portion of the voters.

"The sentiment is echoed in a blog on the popular site Tech Crunch that's gone viral in the past few days. "On the night of your acceptance speech, just before you walked on stage, 'you' sent out an email saying 'I will be in touch soon' -- but you disappeared and all we were left with was the strange feeling you get when your older brother ditches you for his cooler friends," began the post, which blogger Edo Segal wrote as an open letter to Obama."

He goes on to quote many who say that Obama the candidate ran a new and different campaign based on change, but governs in the same old way politicians always have. The New Media Strategy has also seen a major change. While it was a major facets to the campaign with their director reporting directly to the campaign manager, the White House new media strategy falls under one of the many outreach tools in the communications department.

Not mentioned by Vargas is the office of public liaison whose youth outreach representative is the same as the faith based and non-profit outreach person. Can you honestly tell me that one person can handle all of the faith based outreach and non-profits and then have time to do an aggressive youth outreach strategy? Not a chance. At the same time, faith based groups are accustom to having a seat at the table in the White House, and they know very well how it works. Youth are accustom to being ignored, so they aren't as likely to stick their neck out and demand a meeting with someone from the White House.

At one point there was a monthly conference call among youth leaders and the office of public liaison, but one youth leader who asked to not be identified said it was such a colossal waste of time that he quite participating and he doesn't know if they continue.

While the process might seem trite, the result has the appearance that youth aren't a major concern to the White House, the DNC, or OFA.

By contrast, Congressional Democrats have done a lot more in efforts to reach out to young people. While I consistently criticize Chris van Hollen for the DCCC's youth outreach program being "showing candidates the data," chairs of Congressional Committees (particularly Rep. George Miller) have worked with several youth groups and young leaders as partners in policy initiatives and in passing legislation. The Speaker's office continues to be an open door to young people, and Speaker Pelosi reaches out to youth more and more each year.

Reporters and bloggers have been writing about the upcoming election saying that young voters won't come out for the midterms. It's the same thing we've heard over and over again, and each year we work to show them they're wrong, we are relevant, and that we can't be ignored. But in a year when we've been so consistently ignored, placated, and the once "You're the change in this movement" has turned into "you think you're invincible," makes me wonder if its a self fulfilling prophecy.

Vargas closes his piece quoting youth ally Morley Winograd who spoke about the outreach the White House could have done around health care to guarantee it was passed:

"There's been a missed opportunity here in showcasing the kind of youthful, optimistic, hopeful energy that greatly Obama benefited from during the campaign," said Morley Winograd. . ."But of course it does not at all mean that the opportunity has gone away."

In her first outreach event to the Millennial Generation, former Kansas Governor now Health and Human Services Secretary Kathleen Sebelius will answer questions by young voters on upcoming health care reform legislation, how the HHS is doing outreach to young people, and what options for young people who continued to be uninsured.

Sebelius was unable to the 80 Million Strong for Youth Jobs summit in July which discussed at length the staggering unemployment rate for Millennials and the over 1/3 of uninsured youth. But former US Senate Majority Leader Tom Daschle spoke at length about health care reform.

Daschle identified 3 main problems with today's system

1. Access - 50 million people he says lack health insurance. But 48% of people who do have insurance don't have adequate insurance or are under-insured.
2. Quality - Daschle reminds us that last year the World Health Organization ranked the United States 37th in the world for quality of health care, behind Costa Rica. The US is 31st in life expectancy and 29th in infant mortality, and 24th in overall women's health.
3. Cost - what Daschle says is driving the debate more than anything. When he was born health care was 4% of the nation's GDP, today its 17%, and when we're his age the CBO projects have it at 32% of GDP. Our nation is going bankrupt because of health care.

Last Monday I was in Washington as Speaker Pelosi, Rep. Chris Van Hollen, and Rep. Kathy Dahlkemper joined with young leaders to announce the Young Adult Health Coverage Act which allows young Americans remain on their health insurance plan until they turn 26. The Congress has taken a strong first step in both dialoguing with youth on their needs, but further acting on those dialogues to ensure policy matches those needs. I've been amazed at how eager Members have been to work with young leaders on many of these issues, and I look forward to the White House taking a similar role.

I look forward to hearing about Secretary Sebelius's take on young people who are uninsured or under-insured and any solutions the White House is proposing. To join in the event register here. It's unclear if there will be video available or if the event will be live streamed but if it is we'll bring you the information.

Photo Credit: Josh Landau/Young Invincibles

Continuing our coverage from Washington DC, House Speaker Nancy Pelosi along with Reps. Chris Van Hollen (D-MD) and Kathy Dahlkemper (D-PA) held a press conference with representatives from several youth organizations in support of the Young Adult Health Coverage Act which allows young Americans remain on their health insurance plan until they turn 26.

According to the Speaker

"Young adults are the most uninsured group in the country. They often lose coverage at age 19 when they graduate from high school or a few years later when they graduate from college. Once they enter the workforce, they face new obstacles to getting insurance. Today, they are speaking out and their voices are being heard. For many weeks, young Americans have added to the call to the chorus for reform. They have offered specific proposals about health insurance reform that works for everyone.

Our legislation answers their call by: ending discrimination based on pre-existing medical conditions, capping out-of-pocket costs, focusing on preventive care, investing in workforce training to boost the number of primary care doctors and nurses, creating a health insurance exchange to give Americans a better deal in the individual insurance market, and speaking personally, a public option in the House bill. Today, I’m pleased to announce that our bill will allow young people to stay on their parents’ policy until their 27th birthday if they need it.

Our young people are our future. This is our opportunity to lay a foundation for growth, progress, and prosperity for our youth, and provide affordable, quality health care to every American. It is an opportunity we will not miss."

The Speaker has been a consistent ally to the youth movement, frequently lending her leadership to issues that support my generation. Reps. Van Hollen and Dahlkemper should be proud of their work on something so meaningful in the health care battle.

Here is a letter sent to Sen. Max Baucus (D-MT) on behalf of a coalition of youth activist organizations fighting the good fight on health reform:

September 25, 2009

The Honorable Max Baucus
H-232, US Capitol
Washington, DC 20515

Dear Senator Baucus:

We are writing on behalf of organizations representing young Americans across the country whose lives will be dramatically impacted by health care reform. We applaud many of the aims of America’s Healthy Future Act, particularly efforts to provide universal coverage to all Americans.

However the current legislation falls short on a number of key provisions that must be addressed. We urge you to make health insurance more affordable for young Americans by expanding the income range eligible for subsidies and lowering the caps on the percentage of income individuals might pay for premiums. We urge you to allow young adults to remain on their parents’ insurance policy until the age of 26 so as to reduce gaps in coverage and preserve continuity of care. We also urge you to add a public option to make the new health insurance exchanges more competitive and lower costs for young consumers. We strongly believe that comprehensive, affordable health insurance should be available to all Americans, young and old.

We are aware of the inclusion of a “young invincible” plan in the current legislation that is “effectively a catastrophic with no coverage below the HSA out-of-pocket limit except for preventive benefits and
services.” (Snowe Amendment #F5 accepted into the Chairman’s Mark) While we believe the focus should be on improving subsidies so everyone can afford comprehensive coverage, if the “young invincible” provision must be in the legislation it needs to include certain key provisions:

• The HSA limit is now $3,000 and is far too high a deductible for even healthy young Americans. Common injuries that need treatment could spell financial ruin for young Americans, 80% of whom earn less than $40,000 per year. The allowable deductible should be significantly lowered.
• “Preventive benefits and services” must be defined broadly to include a wide variety of common preventive treatments including regular check-ups, screenings, and gynecological visits.
• The plan must include coverage for chronic conditions that impact those 18-34, such as asthma, diabetes, hypertension, and sinusitis, which would not count against the deductible. Over 15% of young
Americans deal with chronic health care problems. Without access to proper case management, not only do they suffer but it costs the system in the long-run.

Thank you for your leadership on this issue. Young people are counting on you to deliver on the promise of reform and a better future for all Americans.

Sincerely,

18 in ‘08
80 Million Strong
Advocates for Youth
Black Youth Vote
Bus Federation
Campus Progress
Daily Get Up
Forward Montana
Rock the Vote
Student Association for Voter Empowerment
Young Invincibles

While Baucus's track record doesn't give much hope to the letter having much of an effect on the legislative output, there's a bigger fight than what might happen with Baucus's legislation being discussed in the Senate Finance Committee this week. As this Times piece seems to indicate, there's some kind of latent momentum going for the public option outside of the more conservative Finance Committee, thanks to the GOP:

The Senate floor, and certainly a conference with the more liberal House, will be more receptive arenas, Mr. Schumer and others predict. Ultimately, the liberals in Congress, as well as their allies in organized labor, expect to be able to shape the final product more than they had hoped just weeks ago.

That unnerves the more conservative Democrats, many of them from Republican-leaning districts and states.

Liberals have been emboldened by two factors. One is the failure of Senator Max Baucus of Montana, a more conservative Democrat who heads the Finance Committee, to get any Republicans to support his draft legislation, after months of trying. That doomed President Obama’s goal of bipartisan backing for a health care overhaul, and now leaves party liberals arguing for a distinctly Democratic health plan.

“One of the strongest arguments against a public option has been that the Republicans will never go for it,” Mr. Schumer said. “Well, the Baucus bill doesn’t have a public option, and they’re still not for it in any way, with the possible exception of Olympia Snowe,” a moderate Republican senator from Maine, who has not ruled out supporting the overhaul that Mr. Obama is seeking.

The second development that has encouraged liberals is recent polling, including some done for The New York Times and CBS News in the last week, that gives Democrats a clear edge over Republicans as the party favored to deal with health care issues. The same polls show significant support for a public option despite months of criticism from Republicans, who describe it as a government takeover of health insurance.

Should Schumer be successful in staging a larger debate following all committee deliberations when the legislation is on the Senate floor, the stipulations made in the youth coalition letter appear to have a larger chance of being incorporated into the final Senate bill.

The best thing for everyone to do at this point is to bombard your respective senators and make sure they understand why youth want the public option, as well as the other caveats made in the letter above.

A youth organization has finally got involved in pushing young people's hope for health care reform. Rock the Vote is starting with a

"30 second television spot featuring Scrubs stars Zach Braff and Donald Faison encouraging young Americans to show they care and “demand health care now” by visiting www.rockthevote.com or texting the keyword “HEALTH” to RTVOTE (788683). The ad uses the actors’ roles as “fake doctors” to educate young people about health care reform and demand that “the suits in Washington cover more than just their own asses.”

Braff and Faison’s PSA reinforces to young Americans’ that they have the most to gain – or lose – in health care reform. Americans between the ages of 19 and 29 have the highest uninsured rate of any age group. Nearly 1 in 3 is uninsured. In addition, half of uninsured 19- to 29-year olds work full time, but aren’t covered through their jobs and can’t afford health care because of low wages.

Faison believes that its important Washington listen to young people beyond trying to get themselves elected. Aside from a few select members, he's absolutely correct.

"According to a recent Survey USA poll, 91% of young people ages 18-34 are paying attention to the health care debate and are most supportive of the public option (overall 58% of American say it is “extremely important,” but among 18 to 24 year olds that jumps to 68 percent and 65 percent for 25 to 29 year olds)."

I hope the campaign isn't too late in the game to have a meaningful impact. After a summer filled with teaparty people being the loudest voice it would be great if a similarly loud advocate group could work through the process to connect on a more rational level with elected officials.