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Can We Talk?

This week, ITUP is on the Covered California bus tour roaring around the Golden State to raise awareness about the beginning of open enrollment on November 15 (this Saturday!). At each stop, we’ve heard stories of how people’s new coverage has made a huge difference in their lives. A woman in Fresno movingly spoke about how her coverage allowed her to catch and treat an aggressive uterine cancer. After hearing from these Californians, I feel like I need to use the late Joan Rivers’ favorite catchphrase for this post because I think it’s good to have a little check in about the importance of having health coverage. So, can we talk?

As you may have suspected, one of the big ideas behind the strong push to enroll people in coverage is that having health insurance would allow people to be healthier (in addition to giving them added financial security, but I’ll save that for another blog). It’s one of the main reasons why so many people have been working so hard to establish universal health insurance coverage in the United States for roughly 100 years now. (Yes, in addition to being a huge enthusiast of the great outdoors and the Panama Canal, Teddy Roosevelt started the push for universal health coverage in the United States.) Now, as we’re about to dive into another open enrollment period, it’s important for us to remind ourselves what health coverage is doing to get people healthy.

The New York Times recently published an article about this topic, and it offers some interesting findings from a number of well-regarded sources. As you may have heard, the ACA strongly emphasizes preventive care (no cost sharing!) to catch conditions early. Many inquiring minds are now wondering if we have any evidence of healthier behaviors or—the ultimate goal here—improved health outcomes in the time since different pieces of the ACA took effect. While it’s still early, the answer appears to be “yes,” and the most promising trends are popping up among young people.

Improving health outcomes is a difficult and sometimes elusive goal, yet we have some evidence that young adults (18- to 25-year-olds) are using more needed and preventive services. For example, more people in this group who have a mental health condition are now accessing treatment. Fewer adults in their early 20s are forgoing medical treatment because of cost, and a greater share of this group reports having a regular primary care provider. An increasing percentage of young adults also report being in excellent health. Among adults more broadly, colonoscopy rates have improved among those with private insurance, which could be a result of these services being available without cost sharing.

It’s true that most of the positive movements have occurred in care-seeking behaviors, but it’s encouraging that more young people are reporting that they feel that they are in excellent health. The increase in preventive care and needed mental health care will also hopefully result in better health outcomes. In any case, as we encourage people to enroll in coverage again during Covered California open enrollment, let’s make sure to mention the benefits that allow people to get and stay healthy. Although shots, colonoscopies, and mammograms might not be the most enjoyable events that find their way into your planner, they have a decent chance of helping you stay healthy through the years. Just another reason to say, “I’m in.”


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