HEALTH CARE/Joan Retsinas

Congrats to Graduates!


To the 2006ers: Congratulations.   And welcome to the world of the uninsured.

Consider your sheepskin an entrée to Adulthood in America. And adulthood (at least working-age adulthood) doesn't come with an insurance card.

Until now, you have been fortunate. Either your parents covered you under their policy; a state program covered you; or your school's insurance came to the fore. But once you graduate, that good fortune is over. You've left academia for "the real world."

The "real world" is a harsher place.

Don't look to your parents for coverage. You are no longer a "dependent." Regulations are explicit: after you reach 19 and stop being a full-time student, most policies won't let parents add you to their plan. Parents can, of course, pick up the tab for an "individual" [non-group] policy for you, but those can run as high as $8,000 annually. After footing several years of tuitions, your parents may want a breather from the fiscal ties of parenthood.

Don't look to your alma mater for help. School alumni networks might help you get a job, an apartment, or a date; but they won't help you get insurance. And school insurance programs serve only full-time students, not new graduates.

As for the state-subsidized programs (Medicaid and Children's Health Insurance Program), most cut coverage by age 19. From government's vantage, in loco parentis stops then.

The Commonwealth Fund has publicized the grim data: In 2004, 13.7 million adults ages 19-29 were uninsured, up from 11.2 million in 2000.

So if you want to take 6 months to hitchhike around Europe, concoct nifty new software, or write the great American novel, you may have to put your plans on hold.

A lot of you will go without insurance for a while. The Commonwealth Fund reports that 50% of high school graduates who do not go on to college and 40% of college graduates will be uninsured for a period after graduation.

But a few months without insurance is risky: a broken arm, or an appendectomy, can saddle you with mega-debt. Also, if you have an illness (asthma, diabetes, depression ... you fill in the blank), any period without health insurance leaves you vulnerable to "pre-existing condition" exclusionary black-outs. In short, once you do get insurance, your insurer can refuse to pay for disease-related treatments for six months, often up to a year.

The prudent post-graduation plan is to get insurance.

Doing so is tricky.

The most obvious solution is to get a job. But a job doesn't guarantee you insurance. Many employers don't provide insurance, provide it at premiums too high for you to pay (especially if you are paying off school loans), or have a probationary period before they will sign you onto the company policy.

You can join the armed forces -&endash; but health insurance may not be sufficient incentive to enter that "real world."

You can rob a bank. Prisoners are entitled to health care while in prison &endash;- but not while out on probation or parole. So nix that plan.

The easiest recourse: stay in school. That can buy you more years under your parents' policy (COBRA regulations allow parents to cover full-time students up to age 25; but parents must pay the full cost of the policy), or under your school's policy. Some legislators are proposing to make private and public insurers extend the fiscal umbilical cord for students beyond age 19.

But you may not want to stay in school. You {and your parents) may want a respite from tuition bills. Furthermore, that only delays the crisis. Eventually your money, or your zeal for learning, will end. And you'll end up in the "real world" of the uninsured.

Surely your sheepskin marks your intelligence. Surely you recognize the best solution: national health insurance. In your post-graduation euphoria, I hope you lobby for it.

Joan Retsinas is a sociologist who writes about health care from Providence, R.I. Email

From The Progressive Populist, July 1, 2006

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