'I don't need health care': Millennials threaten success of reform

To work, health care exchanges need young, healthy people to sign up, but some won't and are willing to be fined

Stacie Smeal, a fitness instructor in New York, says that she doesn't need health care and that the idea of a government mandate "disgusts" her.
Al Jazeera America

NEW YORK — Stacie Smeal’s entire life is about living healthy. She eats only organic food; she works out daily for hours at a time. The fitness entrepreneur has even launched a website encouraging people to follow her habits. Yet one thing lacking from her life is medical insurance.

“In general, I don’t need health care,” Smeal, 27, said. “I exercise and eat healthy, so I’m generally a healthy person.”

She lives on her own in New York and doesn’t have a full-time job. She said she simply can’t afford medical insurance. Yet as the launch of the Affordable Care Act (ACA) nears, she is among millions of Americans who will soon forced to buy insurance.

“It disgusts me,” Smeal said of the health care law. She said she feels as if she’s being punished for striking out on her own and worries the new requirements will push her to full-time work just so she can afford insurance.

“I just can’t comprehend working 35 hours a week, where I’m bringing in, after taxes, $200, $250 a week, just so I can have health insurance that I might use once that year,” she said. “Who wants to work just for your health insurance?”

Yet it’s young people like Smeal that Barack Obama's administration has said are most needed to make health care reform a success. The new insurance exchanges, which open Tuesday, hope to attract at least 2.7 million of the 17 million uninsured 18-to-34-year-old Americans. That age group is dubbed the young invincibles and is the demographic least likely to be insured.  Enrolling young adults, who often pay for but rarely use health insurance, is needed to keep premiums low overall.

“If they don’t get a lot of young people to sign up, this bill becomes much more expensive than the president thought it would be,” said Basil Smikle, a political consultant and an adjunct professor at Columbia University. “The president is counting on the fact that there are a number of young people that can spread out the risk and allow some of the sicker, older folks to be able to benefit.”

Fine with a fine?

Critics and supporters of the ACA have rolled out aggressive campaigns targeting millennials. President Obama often encourages them to sign up when he promotes the health care act. People who remain uninsured in the first year will face a fine of $95 or 1 percent of their household income, whichever is more.

Still, some young people, like Hash Halper, a 33-year-old art gallery owner, will risk the fine.

“I don’t have money to pay for health care, so maybe I don’t have the money to pay for your fine,” he said. “There are so many taxes now, this just seems like another one on top of everything else.”

For a typical 27-year-old, premiums could range from $129 to $240 a month, according to recently released government figures. But rates vary, depending on a person's location and coverage. Also, subsidies and tax credits are available to help lower costs.

"If you're, say, a 27-year-old young woman, don't have health insurance, you get on that exchange,” Obama said recently, “you're going to be able to purchase high-quality health insurance for less than the cost of your cellphone bill."

Shawna Doherty, 30, said she would check out the new health care marketplaces. She’s been uninsured since she left full-time work to start her own event-planning company three years ago. She said it’s been cheaper for her to simply pay for the occasional doctor visit rather than buy insurance.

“I’ll look into it and see if the plans make any sense for me and my life,” she said, “but I really don’t need to go to the doctor that often.”

Smeal remains unconvinced. Like many her age, she doesn’t see the point in buying something that she’s convinced she’ll rarely use.

“Unless I get into a life-critical accident,” she said, “I don’t need health insurance.”

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