Anthony Wright is executive director of Health Access California, the statewide health care consumer advocacy coalition. He blogs daily at the Health Access WeBlog and is a regular contributor to the Treatment.

In the last several weeks, in ceremonies across the country, hundreds of thousands of Americans have become uninsured. I’m not talking about plant closings, or court proceedings for divorce or bankruptcy. I’m referring to high school and college graduations.
 
Even if graduates were going into a job market that didn’t have double-digit unemployment, the likelihood is that many, if not most of them, will become uninsured for at least some period of time.
 
Twentysomethings are disproportionately uninsured more than other age groups. (This Health Access fact sheet offers some statistics.) For too long, this has been attributed as a matter of choice--the so-called “young invincibles.” But my review of the data suggests that young people take up employer-based coverage at similar rates to older workers. Most of the difference is not really about age or attitude, but income and job type.
 
Graduates who gain employment in this economy will likely find it in low-income, entry level jobs that are, relative to other jobs, less likely to offer health coverage. Even those graduates on professional tracks start at lower incomes. They may face months or even years to qualify for on-the-job benefits.
 
Some states, from New Jersey to Utah, have put in place policies requiring insurers to extend group family coverage to dependents well into their 20s, in recognition of the fact that many young adults are taking longer to finish their educations. Some of the federal health reforms now under consideration in Washington--including a few Republican proposals--would make this change nationally. But this would help  a limited, albeit growing, population of those still living with their parents.
 
Health reform’s real promise for young adults is twofold: (1) expanding on-the-job coverage, especially in the retail, restaurant, and service jobs that are mainstays for young adults; and (2) providing income-based subsidies to help lower-income young adults afford coverage.
 
Today, those young adults can buy in the individual market. But frequently they can afford nothing more than high-deductible plans. For many young people with little assets but significant student loans and debt, a high-deductible product doesn’t make much sense. The cost of the deductible might be enough to tip you into bankruptcy, before the coverage kicks in.
 
Here’s hoping that our new graduates get the jobs they want--and the health reform that they need. 

--Anthony Wright