Uninsurance and medicaid eligibility among young adults in 2025

WHAT IS THE ISSUE?
“Young adults (ages 18 to 24) are more likely to be uninsured than any other age group, yet many of them are eligible for Medicaid or premium tax credits (PTCs) on the Marketplace. Reaching out to this age group to raise coverage rates could help set the groundwork for healthy and productive lives. This brief projects insurance coverage of young adults in 2025, after Medicaid unwinding is complete but before expiration of the enhanced PTCs, and describes the demographic, eligibility, and geographic characteristics of the remaining uninsured to support outreach, enrollment, and other policy efforts. We include a special focus on uninsured young adults eligible for Medicaid but not enrolled.

[Related: How Medicaid helps mothers, caregivers and children]

WHY THIS MATTERS
The coverage landscape for young adults differs from that for other groups. The Affordable Care Act included several provisions that increased access to insurance coverage among young adults, including allowing children to be insured through their parents’ plan until they turn 26, expanding Medicaid eligibility to adults with incomes up to 138 percent of the federal poverty level, and providing PTCs to purchase insurance on the Marketplaces. State rules for Medicaid and Children’s Health Insurance Program income limits by age group vary widely, however, making eligibility for young adults complex and state-specific.

Having health insurance coverage, particularly Medicaid coverage, improves access to care and reduces delays in care because of cost for young adults. Reaching uninsured young adults to encourage enrollment in Medicaid, Marketplaces, or other insurance programs for which they may be eligible, as well as expanding eligibility for those who do not currently qualify, is important to supporting their long-term health and supporting their growth into healthy and productive adults throughout their lifespan.

WHAT WE FOUND

Our key findings are as follows:

• • We project 3.6 million young adults will be uninsured in 2025, an uninsured rate of 11.3 percent.
  • The uninsured rate for young adults will be highest in Texas (20.9 percent), Alaska (17.6 percent), and Florida (17.0 percent) and lowest in the District of Columbia (4.3 percent), New York (4.6 percent), and Iowa (5.4 percent).
  • Young adults will be more likely to be uninsured than any other age group: 11.3 percent will be uninsured, compared with 4.2 percent of children and 9.6 percent of adults ages 25 to 64.
  • Young adults’ uninsurance will vary by state and subgroup. For instance, uninsurance is projected to be higher for young adults who live in states that did not expand Medicaid eligibility under the Affordable Care Act, are ages 20 to 24, are men, are Hispanic, are not students, and have low incomes compared with their counterparts in other subgroups.
  • About half of uninsured young adults are projected to qualify for publicly supported health insurance coverage in 2025. About 1.1 million uninsured young adults will be eligible for Medicaid while 0.6 million will be eligible for Marketplace PTCs.”