Penalties Could Motivate More To Sign Up For Health Insurance

Oct. 27--With the Affordable Care Act's annual open enrollment period set to begin Sunday, supporters of the federal health insurance marketplace face a major challenge: How do they convince uninsured 18- to 34-year-olds to sign up? Maybe the rising cost of going without health insurance will get their attention.

"They are a tough group to reach," said Neil Deegan, Pennsylvania state director for Enroll America, a Washington, D.C., independent nonprofit organization that helps the uninsured get health coverage.

Nationally, he said, about half of the marketplace-eligible uninsured fall into that 18-34 demographic and Pennsylvania may reflect that ratio as well.

This is a group which, after all, is sometimes referred to as "the young invincibles" who believe the medical system has little to offer them at this stage of life. Between college loans and a soft job market, a health insurance premium may not score high on the must-buy list.

"There's no question that that demographic is the population that we need to see enroll because they're the healthy people who are supposed to offset the unhealthy people," said Shari Herrle, vice president and director of compliance for Henderson Brothers insurance agency, Downtown.

"They are a tough group to convince they need the insurance because they don't get sick very often and, if they do, they get over it quickly. It's not a big ticket item for them."

This time around, there are big-ticket implications for those going without insurance.

Back in 2014 -- the marketplace's inaugural year -- the fee on the uninsured for not buying insurance was $95 per person (up to $285 for a family) or 1 percent of household income over $10,150, whichever amount was higher.

IRS Commissioner John Koskinen reported to Congress last summer that in 2014, the most recent data available, 7.5 million taxpayers reported making a total of $1.5 billion in "individual shared responsibility" payments, with the average payment about $200. About 40 percent of all payments were $100 or less.

Here's why those payment numbers likely will go up: For 2015, the fee for going without insurance grew to $325 per individual (with a maximum $975 per family) and 2 percent of household income.

Next year, the individual fee goes to $695 (with a maximum $2,085 per family) or 2.5 percent of the yearly household income, again whichever amount is higher.

"If you don't buy insurance," said Mrs. Herrle, "be prepared to pay."

Mr. Deegan said the marketplace is a good buy even without considering the IRS fee.

"There are plans for as little as $33 a month after subsidies, depending on their income. Insurance is available, it is affordable and there is help out there to sign up."

What is not so affordable, he added, is an unexpected hospital bill.

"No one expects to get sick. No one expects to get hurt. But it happens," he said. "Say you're 28, you go out for a run, trip over a bench and break a leg. That could end up costing $10,000, $20,000 or $30,000. Without insurance, you're on your own to pay that."

Mr. Deegan said there will be an information and sign-up session from noon to 4 p.m. Sunday at the Eastside Neighborhood Employment Center, 5321 Penn Ave., East End. Two sessions next week will target younger health insurance shoppers: one at CCAC-South, 1750 Clairton Road, West Mifflin, 11 a.m. to 3 p.m. Monday and the other at the University of Pittsburgh's Cathedral of Learning, Oakland, from noon to 6 p.m. Thursday.

Appointments also can be scheduled online at www.gcaconnector.org.

Steve Twedt: [email protected] or 412-263-1963.

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