Conservatives often dwell on "the young invincibles"--young adults who opt out of buying health insurance not because they can't afford to do so, but because they don't think they need to be covered. On Fox News's "Hannity & Colmes," for example, Dick Morris claimed last year that most of the uninsured "are for the most part young, single people who don't want health insurance and haven't bought it because they don't want it." And if people are voluntarily choosing to be uninsured, the thinking goes, we don't really need to enact sweeping reforms that would make coverage more available.  

story in yesterday's New York Times show just how misleading that argument is. Young adults--aged 19 to 29--are the largest and fastest growing group of the uninsured. But in many cases--and quite possibly most, though it's difficult to nail down statistically--it's not because they don't think they need health insurance. It's because they are more likely to be new, more temporary workers who are ineligible for employer-based coverage. As a result, they're now relying on what the Times describes as "a scattershot network of improved and often haphazard health care remedies"--pills scrounged from friends, stockpiled medication, and self-diagnosis via the Internet. It's not that uninsured young people don't want insurance; many simply can't afford it. According to the Commonwealth Fund, about 30 percent of these uninsured young people are below the poverty line. In the words of one uninsured musician: "It's not like I think I'm invincible, I'm 29, the world can't touch me. It's the very opposite of that. I've got to make rent and eat."  

While organizations like the Freelancers Union have tried to fill in the gaps, such membership groups are necessarily limited to a small range of industries and have other exacting criteria. Governor Paterson's plan to extend coverage to young people under their parents' plans would cover a projected 80,000 more New Yorkers--but that leaves nearly 700,000 in the state still uncovered. Altogether, it's a case study that shows there are too many gaps to fill, and neither the states nor individuals should be left to patch together a solution all by themselves.   

--Suzy Khimm