Nicholas Williams of East Islip is concerned because he’s a Type 1 diabetic and is about to fall off his parents’ health insurance plan. Credit: Barry Sloan

Young adults ages 19 to 34 have the highest uninsured health care rates in the country, according to census data — and Nicholas Williams hopes not to enter into that category.

He's anxious, though. That's because Williams will turn 26 next month, making him ineligible to remain on his parents' health insurance plan under Affordable Care Act regulations.

"Twenty-six is the end of the road for me," Williams said, referring to his current ACA plan. "I’m definitely nervous. … You're cut off. I'll be on my own."

Before implementation of the ACA in 2010, health insurers set the age limit, which varied.

Williams, who lives with his family in East Islip, is frantically job hunting, with multiple interviews lined up, he said. Williams said he has a degree in social studies from St. Francis College and is interested in a job in customer service.

His health insurance needs are not far from his mind, he added, noting he is a Type 1 diabetic, something he said he's been since he was 15.

"I’m on an insulin pump, and I also have a blood glucose monitoring system that tracks my blood sugar every five minutes. These devices make my life easier. It helps me manage my diabetes," said Williams, who has worked part time and in temporary jobs that didn't offer insurance. The cost "is manageable with insurance. I can’t imagine how much that would cost without insurance."

According to the 2019 American Community Survey from the U.S. Census Bureau released Oct. 26, people ages 19 to 34 were the largest share of uninsured of any age group in the United States, at 15.6%, 0.4 percentage points higher than in 2018. That compares with 5.7% for those under 19, 11.3% for adults ages 35 to 64, and 0.8% for individuals 65 and older in 2019.

And the uninsured share of 26-year-olds was the highest among any single-year age, at 18.3%, which was 3.6 percentage points higher than the uninsured rate for 25-year-olds, the bureau said. Twenty-seven-year-olds had the next-highest uninsured rate, at 17.5%, in 2019.

The census bureau report said, "All adults may receive coverage through their employer, through public coverage or through purchase on the health care marketplace. However, young adults may be less likely to purchase health insurance coverage, and therefore more likely to be uninsured than other age groups."

Daniel Lloyd, 34, founder and president of Minority Millennials, a grassroots nonprofit that works to represent minorities and millennials in policies, said health insurance coverage is on the minds of many in his group.

"A lot of members are focused on entrepreneurship, and many stay with jobs only because of health insurance," Lloyd said. "So that impedes their desire to establish their own businesses."

Lloyd, who also works for the Babylon Industrial Development Agency, recalled how a similar concern affected his career trajectory. When he reached the age cutoff, "I was let off the health insurance. I was an entrepreneur at that time. I wasn’t concerned so much because I didn’t have any health risk at that time."

Then, marriage and fatherhood came, and "you have to take that into consideration," Lloyd said.

Local health observers say a combination of factors are at work in driving up the number of uninsured young adults.

"So, we don’t have a mandate anymore that they are required to have insurance," said Janine Logan, senior director of communications for the Nassau-Suffolk Hospital Council. She was referring to the "individual mandate" tax penalty that was part of the ACA and was repealed in 2017. Logan added that young adults "often think they don’t need medical care."

Logan, alluding to the impact of the coronavirus pandemic, added, "I think we will probably see more uninsured after we look at the full year of 2020."

Rebecca Sanin, president and chief executive of the Health and Welfare Council of Long Island, cited several issues in an email. She said some young adults are enrolled in health plans through their college or university and, "If there has been disruption there, that may cause an issue."

In addition, she noted they could lose coverage if they had been on their parents' plan and they reach the age limit, or they could have lost a job and their health coverage with it.

Sanin said her organization has been helping clients enroll in health insurance for 20 years. She added, "I would still make the case that the ACA provides protections for young people under 26. If that protection is lost as a result of assaults to the ACA, we anticipate that our young adult population will be made that much more vulnerable when it comes to access to care."

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