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Why Young Kentuckians Don't Sign Up for Health Insurance

Preston Holmes is a 25-year-old single father; he has a 6-year-old special needs daughter with a chronic health condition.

Both Holmes and his daughter are uninsured.

“We paid for a lot of things out of pocket--MRIs, ultrasounds, specialists’ visits. It adds up really fast," he said.

Holmes is an example of what the insurance industry calls "young invincibles." These are the 19-to 34-year-olds who forego health insurance because they see themselves as healthy and immune to health problems.

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Holmes, a Taylorsville resident, hasn’t had health insurance since 2011. He said it wasn’t because he didn’t see the value.

It just wasn’t a priority.

“Life gets busy and health insurance should be one of the things on the forefront of your mind, but it wasn’t. It sat in the back of my mind, and I never really thought about it,” he said.

He’s not alone.

Young adults are more likely to have lower incomes as they establish their careers, said Genevieve Kenney is co-director of the Health Policy Center at the Urban Institute in Washington, D.C. They are less likely to have employer-sponsored coverage and less likely to have health insurance through a spouse. They're not as likely to qualify for Medicaid, too.

"So they really fell through the cracks,” Kenney said.

A 2014 Deloitte survey of young adults and health insurance found that 66 percent of respondents were uninsured because they couldn’t afford coverage.

Only 26 percent of respondents felt the cost of health insurance outweighed the benefits, and 19 percent said they felt healthy and didn’t need health insurance.

Carol Kloenne, health insurance advocate at the University of Louisville's campus health services, helps students navigate the sometimes confusing world of health insurance.

She hears all sorts of reasons why students don't enroll, but she said not all students want to go uninsured. Some don't qualify for coverage under Kentucky's health exchange because they aren't permanent residents.

Kloenne said there really is no reason for young people to not to at least explore coverage options. That could mean asking to stay on a parent's insurance plan until they're 26, or logging on to a state or federal exchange to see if they qualify for Medicaid.

"Know what it is and know what you're turning down instead of just not exploring your options,” Kloenne said.

Getting more young invincibles insured may be as simple as providing them with the information.

Forty-seven percent of 19 to 34-years-olds don't know that open enrollment is once a year, 45 percent are unaware that federal subsidies are available to help with costs, and 54 percent have never visited healthcare.gov or a state-based exchange website, according to the survey.

Holmes recently got help from a Kynector--whose job it is to assist people enrolling through the state's healthcare exchange--at the Jefferson Community and Technical College campus in Shelbyville.

He has other ideas as to why his peers don't enroll.

“What’s somebody 19, 20, 21 thinking about? They’re thinking about hitting the club or going out and having a good time. They’re not thinking about health insurance and the future,” he said.

This year, for the first time, being uninsured will lead to financial penalties. People who were uninsured in 2014 will pay a tax penalty of 1 percent of their income or $95, whichever is higher. And for people who spend this year uninsured, the penalty will increase.

Procrastinators have two weeks left to sign up;  2015 open health insurance enrollment doesn't end until Feb. 15.