FOX 8 Special Report: Shopping For Your Health, Part 3 - FOX 8, WVUE,, weather, app, news, saints

FOX 8 Special Report: Shopping For Your Health, Part 3

NEW ORLEANS - They are often grouped under catchy titles: "Millennials," and "Generation Y." In the recently opened Health Insurance Marketplace, some would call them a necessity.

Young adults are viewed as key to the marketplace's success. But in the city of New Orleans, the thought of buying health coverage is far from the minds of many 20- and 30-somethings.

"I probably been to the doctor once in the past decade so," said 27-year-old Ryan Lemoine, who is uninsured.

Come January 1, most Americans must have medical coverage as part of the nation's health care reform law.

"Not a fan of the mandate," said 36-year-old Trey Roberts, who is also uninsured.

For some, the fact that many young adults are not eager to purchase insurance is no surprise.

"Even before the Affordable Care Act they were most prone to just say, 'I don't need health insurance. I'm healthy, I'm young, I'm never going to need it,'" said Louisiana Insurance Commissioner Jim Donelon.

While the health care reform law allows children and young people to remain on their parents' insurance until they are 26, others not covered by their family's insurance are on their own.

"It's a little scary, you know, I try to find different methods of taking care of myself," said Gabriella Garcia, who said she has no coverage.

When it comes to uninsured young adults, Louisiana has a large number.

According to the U.S. Department of Health and Human Services, of the nearly 800,000 uninsured people in Louisiana, 42 percent are 19 to 34 years of age.

Generally, it is not that young people are averse to health coverage - affordability is their concern.

A Kaiser Family Foundation poll from June of this year found 7 in 10 young adults ages 18 to 30 rated having health insurance as "very important." But a quarter of the respondents felt they were healthy enough to forego it.

"Are young people that currently don't have insurance, are they aware that the marketplace exists to go out to buy coverage and are they aware that they might be eligible for subsidies?" asked Mollye Demosthenidy, J.D., MHA, of Tulane University's School of Public Health.

Many young people interviewed by FOX 8 News were unaware of the subsidies in the insurance marketplace, but when they were apprised of them, they showed interest.

"Hopefully, because of my income, I'd be able to skirt the penalty," said Garcia. "But you know I'm back and forth on it because I think it is a good idea to make sure that everyone can have health insurance."

In the insurance marketplace, uninsured people under age 30 have the option of buying "catastrophic" health plans that cover a handful of doctor's visits a year and free preventive care, reducing costs for young enrollees.

"I think they'll have to do the math," said Demosthenidy.

Age aside, if you can afford insurance and refuse to buy it, you won't get a pass from the federal government. The penalty for not having insurance in 2014 is $95 or one percent of your annual income, whichever is higher. The fee will increase every year.

The assessment doesn't only apply to adults. Next year, the fee for uninsured children is $47.50 per child. But the most a family would be required to pay in 2014 is $285.

In 2016, the penalty will be 2.5 percent of income, or $695, whichever is higher.

"And that's the club, or the enforcement vehicle that's supposed to make those young folks belly up and pay this increased cost for them getting insurance, if they don't then the system starts imploding on itself," said Donelon.

Lemoine sees a federal fine in his future.

"I'd rather pay the $95 than get health insurance, you know, I'm never sick, and I don't see why I have to have it," said Lemoine.

"I think it's a risk that we're willing to take," said Roberts.

He feels comfortable in his position.

"For me, with the law the way it is now, no prior pre-existing conditions can you be eliminated for, if I happen to get ill then I'll go out and get a policy, or I will then sign up, they won't be able to deny me," said Roberts.

Twenty-eight year old Sara Suddes will consider the marketplace options.

"Yeah, I think I would. I would rather be covered than you know risk it, I think," Suddies said. "But obviously, you would save a lot of money if you just went ahead and paid the $95. But I think a lot of people probably won't do that."

UNO Economist Walter Lane, Ph.D., who is considered an expert on health care economics, said the penalty for the first year was set too low to serve as an incentive.

"Yeah, it makes no sense at this point," he said.

And some who plan to ignore the individual mandate already have a strategy for paying the penalty in 2014 and beyond.

"We get a modest return in our income taxes every year and that may be the new savings account that covers those unfortunate mandatory expenses," said Roberts.

Regardless of an uninsured individual's age, there are some people who will not face a penalty under the law, including:

--persons uninsured for less than 3 months during the year

--very low income people who cannot afford insurance

--people who are not required to file income tax returns because of low income

--members of a federally recognized Indian tribe

--people participating in a healthcare sharing ministry

--members of recognized religious sects with objections to health insurance

To apply for a religious conscience or hardship exemption you will have to complete an application in the Health Insurance Marketplace. But for many, just nailing down their options is challenging.

"It's not simple to try to decipher all the information out there," said Suddes.

Experts said education is key.

"The more information the better," said Demosthenidy.

Still, others have already made up their minds about whether to buy insurance.

"I'm going to roll the dice with the fine," said Roberts.

There are three ways to enroll in the health insurance marketplace.

--Online at:

--By calling the consumer call center 24/7 at 800-318-2596

--By mail: Health Insurance Marketplace, Dept. of Health and Human Services, 465 Industrial Blvd., London, KY 40750-0001

Open enrollment through the marketplace runs through March 31, 2014.

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