With less than two weeks left in open enrollment, Americans are signing up for health insurance at a strong pace. Yet with the earlier-than-ever deadline of December 15 for 2018 open enrollment through HealthCare.gov, it is more important than ever that uninsured young adults check out their options.

Despite the Administration’s attempts to sabotage enrollment—including cutting outreach and marketing dollars for HealthCare.gov, ending payments for cost-sharing reductions, and disengaging from community-led efforts to educate people about coverage options—more people are enrolling each week than in previous open enrollment periods, according to weekly enrollment numbers reported by the Centers for Medicare and Medicaid Services (CMS). Even still, the pace needs need to increase to compensate for the shorter sign-up window to end the season with strong enrollment for the upcoming year.

We do not yet know the percentage of people who have already enrolled that are young. But if lessons from past open enrollment periods hold true, we can expect the number of young enrollees to surge in these final weeks of open enrollment.

When that happens, those young people may be surprised to find no- or low-cost options. As we wrote previously, the President’s disruptive actions have caused an increase in topline premiums, an increase that, in turn, has a mixed effect on the actual cost for consumers. Higher premiums, particularly when loaded on the Silver plans, means higher tax credits for those who qualify. As a result, upper-income purchasers who do not qualify for tax credits will pay more, but many low- and moderate-income people may see larger tax credits, and as a result, find low- or even no-cost plans when they log in to HealthCare.gov.

About 16 percent of young people are uninsured, down from 29 percent before the ACA took effect—but still higher than the rest of the population. Uninsured young people tend to be low-income, with a median personal income of about $15,000. As a result, these steeply discounted options for 2018 could reach hundreds of thousands, if not millions, of uninsured young people. The impact of those discounts will vary by county, with the greatest impact in counties where the uninsurance rate for young adults is high and the costs are low.

An analysis of the cost of the cheapest plans available for young people in healthcare.gov states shows that:

  • Almost half (42 percent) of counties providing coverage through HealthCare.gov offer a zero-premium plan for thirty-year-olds with an income of $25,000 or less.
    The percentage is 35 and 29 for individuals aged 27 and 21, respectively.
  • States like Alabama, Alaska, Illinois, Maine, Montana, Nebraska, North Carolina, Oklahoma, Tennessee, and Wyoming are states where most if not all counties have free plans for young people making $25,000.
  • In the four HealthCare.gov counties with the highest number of uninsured young people (located in Texas, Illinois, and Florida; see chart), young adults can find plans for anywhere from $8 to $43 per month.
Counties with the Highest Number of Uninsured Young People and the Premiums Available to Them
County Uninsured Young Adults Premium for 30 year-old earning $25,000
Harris County, TX 322,308 $22
Dallas County, TX 194,433 $15
Cook County, IL 192,865 $43
Miami Dade, FL 163,713 $8
 Source: Estimates for total uninsured aged 19-34 by county were obtained from the American Community Survey. To reflect the most recent national estimates for the uninsured, county estimates were scaled proportionally to baseline enrollment. Note: all numbers are rounded and may not sum to totals.


Estimates for premiums net of tax credits for 2018 coverage are the author’s calculations using data from HealthCare.gov. Estimates are not available for State-based Marketplaces. Note: numbers are rounded.

As this open enrollment period heads into its final weeks, we will likely see an uptick in young adult shoppers. And in places like Harris County, Texas, or Miami Dade, Florida, those shoppers may be pleasantly surprised at what they find.Enrollment is open until December 15: visit HealthCare.gov now to review your options and enroll.