Young individuals in Dallas, Houston and throughout Texas are a pretty healthy group in general, but going without health insurance interferes with their access to the health care system, introduces barriers to care when it's needed, and leaves young individuals and their families at risk for high out-of-pocket costs in the face of severe illness or injury.

With that said, 19th birthdays seem to be a crucial milestone in most Americans' health insurance coverage. Both public and private insurance plans treat this age as a turning point for coverage decisions. In Texas, young adults who are not full-time students lose their status as an eligible dependent after 19. A full-time student remains an eligible dependent in Texas until age 25.

Further, Texas health insurance regulation states that most private health insurance plans may not condition coverage for a child younger than 25 years of age on the child's being enrolled at an educational institution. This regulation however does not help every young adult. Self-insured large groups may be exempt from the regulation. And the parents may be simply unable to continue paying a young adult's premiums.

When young adults lose coverage under their parents' plans, regardless of age, their ties with primary care physicians may be cut just when they should be forming stronger links to the health care system and taking responsibility for their own care.

These are just a few reasons coverage is so important for young adults:

o Fourteen percent of adults ages 18 to 29 are obese. Since the 1990s, obesity has increased by 70 percent in this age group - the fastest rate of increase among all adults.

o There are 3.5 million pregnancies each year among the 21 million women ages 19 to 29.

o Injury-related visits to emergency rooms are far more common among young adults than they are among children or older adults.

A recent health insurance survey shows that individuals who are uninsured or have less-than-adequate health insurance have their access to the health care system decreased. More than half of young adults, ages 19 to 29, who either were uninsured for the entire year or had a time without coverage said that they had gone without needed health care because of cost. Delinquent care included failing to fill a prescription, not seeing a doctor or specialist when sick, or skipping a recommended medical test, treatment, or follow-up visit.

In addition, uninsured young adults are far less likely than those with coverage to have a regular doctor. Only one-third of uninsured young adults, ages 19 to 29, had a regular doctor, compared with 81 percent of those who were insured all year. Uninsured female young adults had regular doctors at about half the rate of young women who were insured all year. Male young adults who were uninsured had the most fragile link to the health care system; just 21 percent had a regular doctor compared with 75 percent of male young adults who were insured all year.

Many young adults also have problems paying medical bills or are paying off medical debt over time. More than one-third of all young adults, both insured and uninsured, said that they had experienced problems with medical bills: having trouble making payments, being contacted by a collection agency because of inability to pay bills, significantly changing their way of life in order to pay medical bills, or paying off medical debt over time. Uninsured young individuals were the most burdened with medical bills and debt, with almost half reporting at least one problem.

But contrary to popular belief, young individuals seem to value the protection that health insurance coverage offers. The same survey also found that nearly three-quarters of employed young adults accept health insurance coverage when it's offered, only slightly less than the acceptance rate of workers age 30 or older.