For many of the 13.3 million uninsured young adults in America, it comes as no surprise that their demographic leads those going without health coverage. According to the Commonwealth Fund, a private, non-partisan foundation supporting independent research on health and social issues, in 2005, thirty percent of the forty-five million people in the U.S. who lacked health insurance were between the ages of nineteen and twenty-nine. Texas had the worst record overall, with twenty-five percent of its total population going unprotected. The state actually failed to insure even more of its young adults -- twenty-seven percent.



Many of the young lacking coverage are just entering the workforce and have "aged out" of insurance programs, including state-sponsored plans that usually cut off at nineteen. They can't afford their own, independent coverage yet, and if their employers offer health benefits -- which is a big "if" considering that forty percent do not -- they may not be able to afford the premiums on those, either. Two out of five college graduates went without health insurance for at least part of the year following graduation, as did one-half of those who received their high school diplomas but did not enter college.

"They [young people] are at a vulnerable place in the labor market," said Sara Collins, assistant vice-president at The Commonwealth Fund. The individual market is "difficult to negotiate."

Wide-sweeping reforms have changed the performance of several states' healthcare systems, including laws in seventeen states that forced insurance companies to cover dependent children until at least the age of twenty-four. There are plans to expand the Children's Health Insurance Program, which currently covers 6.6 million children -- including insuring participants up to the age of twenty-five -- but final details of the changes are still being debated in Congress.

The issue is not so much a lack of coverage, but, more specifically, what that lack actually means. According to several independent reports, including studies released by The Commonwealth Fund, those who lack health insurance in the U.S. have less access to high-quality healthcare. In this country, better access to healthcare means better quality, and having health insurance means better access. Ironically, higher quality of care is not associated with higher costs on the state level, debunking the theory that states simply don't have enough money to provide for their constituents.

More efficiently organizing the healthcare system and offering more affordable insurance plans, many argue, would dramatically reduce this problem. Healthcare workers in cities like Dallas, Houston, and Austin have long argued that better organization would make a big difference, where uninsured from the rural parts of the state come to receive care, adding to the masses already in need.

Jack Hadley, of The Urban Institute, confirmed the link between lack of coverage and lack of adequate care. His study, published earlier this year in the Journal of the American Medical Association and highlighted by the Kaiser Family Foundation, proved that the "uninsured generally receive less care and have worse outcomes following an accident or onset of a new chronic condition than those with coverage." Almost ten percent of those lacking health insurance received no care at all after discovering a new chronic condition, and more than nineteen percent of uninsured did not receive any of the recommended follow-up treatments following an injury.

If the rest of the nation could achieve the same low mortality levels "from conditions amenable to care" as the top-ranked states in healthcare, an estimated 90,000 fewer deaths of those under the age of seventy-five would occur every year. If those lower-ranking states, like Texas, could also match their betters in caring for chronically ill patients, four million more diabetics would receive basic recommended care and potentially avoid preventable complications like renal failure and limb amputations.

Texans should pay attention. Diabetes is the sixth leading cause of death in the state, and statistically, those with diabetes are actually less likely to be able to afford medical care than those not afflicted with the disease. In 2005, that meant eighteen percent of diabetic Texans could not afford health coverage. Considering that those with the condition have a greater chance of suffering from cardiovascular disease, stroke, hypertension, high cholesterol, eye disease and other complications, this is, to say the least, a serious problem that eventually drives up costs for others in the state.

Over 1.2 million young people in Texas are living without health insurance coverage. Of those, roughly 229,000 are non-Hispanic whites, 830,000 are Hispanic, and 123,000 are non-Hispanic blacks. Overall, the state ranks forty-ninth in the nation for healthcare, including at the very bottom for the number of uninsured and for "access" to care. Only forty-five percent of Texans actually visited a physician in the last two years for any reason, and forty-nine percent did not see a doctor last year due to cost. In tangible numbers, that means millions are foregoing treatment in Texas alone simply because they can't afford it.

Young people may complain less because, as many experts report, they believe they are a part of the "young invincibles," meaning that young adults tend to believe their age will protect them from the need for coverage. But chronic and fatal diseases can happen to anyone, at any time; HIV/AIDS is affecting more and more young people every day, cancer has never been age-discriminate, and accidents are a part of the risk of simply living. It's a shame that when a condition has the capability of affecting one for the most years of life -- i.e., when it starts young -- so many are going untreated due to lack of coverage. State and federally-sponsored health programs need to be more realistic, and more responsible, about addressing these needs, but so does the group most afflicted by lack of coverage: the young adults.

Being aware of issues affecting accessibility to healthcare is an important aspect of minding your health. How you take care of yourself will certainly affect you as you age, and eventually your wallet, as well.