Read the fine print before you burn your Obamacare card

This is a guest post from Adrianna McIntyre, a graduate student studying health policy at the University of Michigan. Adrianna currently blogs at Project Millennial, tweets at @onceuponA, and will be joining TIE soon as the team’s first intern. 

I have not had the luxury of participating in an “Obamacare draft card burning.” I mean, nothing thrills me quite like burning effigies of things that don’t actually exist, but I’ll try to contain my disappointment. Coordinated by the conservative activist organization FreedomWorks, this is the latest attempt to undermine the implementation of health reform. Sarah Kliff reports:

FreedomWorks believes it has identified a core weakness of Obamacare: the young adults who are crucial to keeping premiums in the Affordable Care Act’s new coverage programs low, the same demographic the White House sees as crucial to the health law’s success.

Young adults tend to have lower medical bills, which would hold down premiums for the entire insurance market. If only the sick and elderly sign up, health costs would skyrocket. FreedomWorks wants to make that happen and, in so doing, doom the law.

Here’s what bugs me: this gimmick—and other efforts like it—aren’t owning up to the full ramifications of foregoing coverage. Sure, there’s the penalty; everyone knows about that. But there’s also the limited open enrollment issue. That’s insurer-speak for “you can only sign up for exchange plans during certain months”; despite the rhetoric, people actually can’t just buy insurance whenever they fall ill. The initial enrollment period is extended, from October 2013 through March 2014. But in subsequent years, enrollment will only last from October to December. There are special exceptions, like losing employer-based coverage during an off month, but I double-checked the regs.“I accidentally burned my Obamacare card” didn’t make the cut.

People pushing young adults to skip the exchanges aren’t saying, “Don’t enroll now… but hey, if you get sick in a few months, we’ll understand if you have a change of heart.” They’re saying, “Don’t enroll now; pay the penalty instead. And if you fall ill, or become pregnant, or get stabbed while doing a good deed and you can’t buy a plan, well, them’s the breaks. That’s the gamble we asked of you.”

Young adults—people of all ages—are free to take that gamble. But they ought to know they’re taking it.

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