Last year, Joshua was out of school for three weeks because of a severe stomach virus. Between two hospital visits and several trips to a family doctor, the bill ran up to around $1,500. His worries were not so much his health or the expense of his illness (his parents’ insurance paid for most of the fees), but the effect it had on his education. Because he missed so much school, he ended up failing that semester.

Health care or education?
Joshua is active, plays volleyball every week, and feels that he is a relatively healthy person. But he is also aware that something could always go wrong with his health. He knows insurance is important, but he cannot afford to pay for his own. “Right now paying my tuition is a higher priority, and school is a full-time job that I cannot afford to miss.”

Taking a risk…
Joshua wants to finish his education as soon as possible. He knows that being uninsured is a huge risk with the big “if” looming in the distance. Until he finishes school his plan for if—or when—he gets sick is to postpone seeing a doctor as long as possible and use the more affordable, over the counter remedies. He simply will not be able to afford more care if anything serious were to happen. “I know my health is important, but tuition has to come first – even over my health. At least for now.”

The Patient Protection and Affordable Care Act allows young adults, under the age of 26, to stay on their parents’ health insurance.

Starting in September, 2010, Joshua will be able to stay on his parents’ insurance until his 26th birthday, at his parents’ choice, regardless of school enrollment status, as long as he does not have access to employer sponsored coverage.

By 2014, once Joshua is done with school and is employed, if he is not covered by his employer, and his income is below $43,320 a year (4 times the poverty level for an individual), he can get subsidies to buy private health insurance from a state-run health insurance exchange, which would offer a menu of choices, including a catastrophic policy available to people under 30.

If Joshua is covered by his employer, he can still buy insurance through an exchange if the premiums of his employers’ plan are too high relative to his income. If he still cannot afford to buy insurance, he could apply for a hardship waiver.