The following is a proposal for PolicyMic's "Open Mic" on "Making Health Care Work For Our Generation." Abridged sections of this proposal were submitted to the "Local Education," "National Engagement," and "Policy Proposals" categories. For more details, please visit http://policymic.com/healthcare.
Increasing Millennial Enrollment in Health Insurance: A Multi-faceted Approach
Signed into law in March 2010, the Affordable Care Act significantly changes the
system by affecting how people receive and pay for healthcare. The biggest and
most important change is the requirement that all Americans who can afford
health insurance must purchase a policy or pay a tax penalty. Those who do not
enroll will face a fine of $95 or 1% of income (whichever is higher) in 2014.
This fine increases to $325 or 2% of income in 2015 and $695 or 2.5% of income
In addition, the Affordable Care Act also: (1) allows young people to remain on their parent’s health insurance until age 26; (2) requires health insurance companies to provide more comprehensive coverage; (3) requires businesses to provide minimum health coverage to employees; and (4) increases coverage of certain procedures in maternal and reproductive health. The goal of these reforms is to maintain and improve quality of care, while reducing unnecessary and inefficient costly expenditures.
The success of the Affordable Care Act depends on enrollment of Americans, especially among Millennials (aged 18-35) in health insurance. To offset the higher health expenditures of older Americans, the Affordable Care Act relies on lower health expenditures from younger Americans. In particular, at least 2.7 million young Americans need to sign up for health insurance. Of the 78 million Millennials in the
more than 27% currently do not have health insurance and 42% do not know about
state health exchanges. This proposal will specifically target Millennials
without health insurance.
As with any major government reform, support from various stakeholders is required to ensure successful implementation. Government agencies must encourage and facilitate the process by educating the public, incentivizing health insurance adopters, and working with activists and public figures to raise awareness. Initiatives, such as Obama’s “Health Care for the Holidays,” are just the start to this process.
1. Education: Teaching Through Academic Institutions, Town Halls, and Other Public Facilities
To increase enrollment among Millennials, these youth need to be educated about what the benefits of health insurance are, why they should enroll in health exchanges, and how to enroll. For younger Millennials still in school, academic institutions can play a major role in this effort. Student groups and the school administration can hold constructive discussions and dedicate days (i.e at the beginning of the semester) that focus on health reform and its implications. Schools can even directly help students enroll by walking them through the process and answering any questions.
This approach requires commitment and participation from both schools and students. Although many academic institutions require students to have health insurance, not all have that requirement. These schools can be incentivized to help students enroll because this would decrease financial burdens, especially for those receiving financial aid. Furthermore, if students do become sick during the academic year, this will minimize unexpected out-of-pocket health costs, especially for the uninsured.
To increase health insurance enrollment among the poor, similar education initiatives could be held at public libraries, town halls, local YMCAs, and other community centers on pre-specified dates. By staffing people at these locations, in addition to call centers, people can directly have their questions answered. This would allow people without access to computers to learn more and determine what the benefits and costs of health insurance are for them.
Implementation of such an education program requires considerable time, resources, and capital.
Commitment and participation from academic institutions, public libraries, town halls and other community centers will be critical to success. Given that many states and citizens do not fully support the new health reforms, they will not support these education initiatives either. However, the main goals of this approach are to inform people about changes to health care and generate discussions. It will be necessary to engage these stakeholders and evaluate what is necessary for their support. It will also be necessary to create simple, yet informative brochures and pamphlets that explain the core concepts of the Affordable Care Act and dispel any myths. Money is needed to prepare and distribute materials, finance local enrollment centers, and train enrollment staff.
2. Financial Incentives: Tax Benefits for New Health Insurance Enrollees
Instead of relying just on penalties to convince people to enroll in health insurance, the
government should also consider creating incentives, such as tax benefits. Since
open enrollment ends March 31, 2014 and the deadline for IRS tax filings is
April 15, 2014, the government could provide tax benefits for new enrollees to
health insurance. For instance, to reach the goal of 2.7 million new enrollees,
a tax deducation of a fixed amount, such as $50-100, for every newly insured
person would only cost $135-$270 million.
Such a small amount could be offset by penalties from those who do not enroll in health insurance. Furthermore, despite the initial loss to the
there would be significant long-term benefits because these enrollees would be
offsetting high costs from older Americans and ensure the success of the
Affordable Care Act. If necessary, the US government could even consider
raising penalty fines to finance a portion or all of the tax benefits for early
adopters of health insurance.
Approval of financial incentives for new health insurance enrollees ultimately depends on the US Congress. Given the significant debates regarding the national budget and the deficit, it may be difficult to decide how to finance such tax benefits. Furthermore, there could also be opposition from people who have already been enrolled in health insurance. If these financial incentives are approved, then the IRS will have the additional burden of verifying that tax filers are indeed new health insurance enrollees.
3. Digital Advertising Campaign: Engaging Corporations and Public Figures
Imagine if enrolling in health insurance was as popular as the latest pop song or artist. People’s health care should be just as important as the latest fads.
Since most Millennials are tech-savvy and aware of popular trends, a digital advertising campaign with celebrities and popular companies would be effective. By partnering with corporate sponsors, such as Nike, Adidas, Coca Cola, etc., and featuring short Youtube videos from athletes, artists, performers, etc. the government can make enrolling in health insurance popular. Another approach is to host online discussions (i.e via Reddit) and encourage popular figures to lend their support for enrolling in health insurance.
With limited time to read about health care changes, Millennials need to be encouraged to learn. Short videos or advertisements with popular figures that explain the core components and dispel the biggest myths would motivate them to actually learn more. Such videos and advertisements can become viral and reach a large part of the population. If Millennials realize the importance of health insurance and the fact that everyone, including celebrities and world leaders, needs it then they will be more inclined to enroll themselves.
Success of a digital advertising campaign largely depends on developing marketing material and receiving buy-in from large corporations and public figures. It will also be necessary for either the government or sponsors to finance creation and implementation of an advertisement campaign. A simple, yet creative message about the importance of health care and health insurance will be critical to success.
A multi-faceted approach that involves education, financial incentives and digital advertising is needed to increase health insurance enrollment among Millennials and ensure the success of the Affordable Care Act. No one approach alone is enough; a collective and broad effort is imperative.
1. Synopsis of "Healthcare 101: The Complete Rundown Of Obamacare You've Been Looking For." http://policymic.com/articles/75475/healthcare-101