July 12--After living most of her life without health insurance, Heidi Chaya isn't even 25 years old yet and she already has more medical bills than she can imagine paying off.

She works three part-time jobs. She drives a used 1991 Honda Accord whose parts have broken down. Traveling on vacation or raising a family feel like distant dreams.

"There's no way out of it, I feel like," said Chaya, 24, of Red Bank. "I just try not to think about it."

Chaya serves as a cautionary tale for twentysomethings who are young, mostly healthy and mostly flat broke. Beginning in 2014, they will be required to buy thousands of dollars worth of medical insurance, causing them to wonder how they can afford it.

After all, many are already are saddled with billions in student loans and a lousy job market. But experts say millions of young people will qualify for good deals on health care if they take time to sort through the complicated law.

Young Americans are the least likely to be insured: almost three of 10 adults who are under 35 aren't covered. And they go to emergency rooms more than any other group except seniors.

For some, time is running short. Ian Sepp of Middletown has been taking advantage of a provision in the health reform law that allows adult kids to stay on their parents' insurance plans until they are 26. Which gives Sepp five months before he will need to find his own coverage.

"For the time being, it's just a struggle to find a job with benefits," he said.

The health care law, given the go-ahead by the U.S. Supreme Court, requires nearly everyone to have insurance starting in 2014 or to pay a fine. The penalty, starting out at a relatively low $95, depending on income, would be far cheaper than paying premiums.

But experts cautioned young adults not to take a chance.

"It doesn't have to be cancer or a heart attack or even a bad car accident," said Karen Pollitz, a health policy expert at the Kaiser Family Foundation whose own son needed $15,000 worth of surgery after he broke his wrist while skateboarding at age 20. "Once you show up in the ER, it starts to cost you some money."

The health law is designed to provide incentives to ease the financial burden.

Many will get Medicaid coverage at virtually no cost. Others will qualify for private insurance at a fraction of the full premiums. And health plans offered under the law will limit individuals' out-of-pocket expenses to about $6,250 per year or less -- a bulwark against gigantic, unexpected medical bills.

The plans also will cover at no charge preventive care such as HIV tests, screening for depression or alcoholism, flu shots, hepatitis vaccine, contraception and pregnancy care. And insurers will no longer be able to exclude or charge extra for people who already have health problems.

Chaya, a student at Brookdale Community College in Middletown, lives with her family, but she isn't on their health plan because they don't have insurance either.

She first was diagnosed with an illness she declined to disclose about five years ago by going to the hospital emergency room -- a trip that cost her $700. Today, she treats it with medication and regular doctors' visits. But she has to pay for it herself.

She is doubtful, too, that she can afford the expense of health insurance; her paychecks go toward medical bills, her car, her cell phone and food. But if there is a way to afford it, she'll jump at the chance.

"It's really frustrating to not have insurance," Chaya said.

The Associated Press contributed to this story. Michael L. Diamond; 732-643-4038; mdiamond@njpressmedia.com

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