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Young adults are most likely to lose coverage when they graduate from high school or college. Half (51%) of high school graduates who don't go on to college have a time uninsured during the year after graduation. Nearly two of five (38%) college graduates will be without health insurance for a period during the first year after graduation.

Age 18 or 19 is a crucial turning point for coverage in many private and public health insurance plans. Nearly sixty percent of employers who offer coverage do not insure dependent children over age 18 or 19 if they do not attend college. Medicaid and the State Children's Health Insurance Program typically treat age 19 as the cut-off for children's coverage, and these young adults will lose coverage unless they can qualify for Medicaid as adults. As a result, uninsured rates jump sharply when a young adult turns age 19: the uninsured rate rises from 12 percent among children under 18 to 31 percent among those ages 19 to 29.

According to the authors, three policy changes could make a significant dent in the problem:

• Extending eligibility for Medicaid and the State Children's Health Insurance Program beyond the current age limit for children of 18.
• Allowing children to be eligible for their parents' health insurance beyond age 18 or 19, regardless of student status.
• Having states ensure that colleges and universities require full- and part-time students to have health insurance, and that they offer coverage to both. Many universities and colleges--as well as the states of Idaho, Massachusetts, and New Jersey--already require students to have health insurance as a condition for enrollment. Federal or state premium subsidies would help offset the costs for students from lower and moderate income families.

The authors note that in the absence of federal action to expand coverage, many sta
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Contact: Mary Mahon
mm@cmwf.org
212-606-3853
Commonwealth Fund
24-May-2006