BALTIMORE — Young adults, often criticized as whiny, entitled and irresponsible, might have the most clout in one of the biggest overhauls of the country's health system ever.
Enrollment in President Barack Obama's landmark health reform plan began this month, and particular interest is being paid to the country's 19 million uninsured young people, who range in age from 18 to 34 and are viewed as key to the legislation's success.
Young healthy people need to buy into the system to help balance the cost of caring for an older population with more health problems who are likely to sign up with less prodding.
"We need a diverse group of people in plans to keep rates reasonable," said Kathy Westcoat, CEO and president of Health Care Access Maryland, a group helping people enroll in health plans. "If all the sick people sign up and not the healthy people, it could affect rates."
Convincing young adults could take work.
The so-called invincible generation is often in prime health, running marathons, trying CrossFit and other fitness trends, and eating anything they want without gaining a pound or seeing a spike in their cholesterol. Doctors and regular checkups might not seem a priority.
"They may have a mentality that it is not going to happen to me," said Peter Beilenson, who has started the health co-op Evergreen Health.
Life might get in the way of coverage for those who think they need insurance. Do they pay the student loan or buy insurance? Can they truly afford insurance if they are just starting in careers?
A recent poll by the Robert Wood Johnson Foundation and the Center for Studying Health System Change found that convincing young adults that health insurance is "a good deal" will have to be a priority.
"They will have to pony up" and decide "whether they think they need it," said Andy Hyman, a senior program director with the Robert Wood Johnson Foundation.
Aaron Smith, executive director of Young Invincibles, a national group working to enroll young adults in health plans under reform, said most young people want insurance. "The vast majority know health care is a priority; it's the question of cost," he said.
Smith's group has found that most young adults will qualify for subsidies or free insurance under Medicaid based on their incomes. Many have been able to get on their parents' plans under a provision that allows them to stay on until age 26.
But like many Americans, young adults are having a hard time understanding the details of reform and weeding through misinformation. Many aren't aware where they sign up for insurance or how to figure out its cost.
If a student is a resident of Kentucky, he or she may sign up on a state exchange, called Kentucky's Healthcare Connection, which works much like a travel website. Go to Kynect.ky.gov. If a student is a legal resident of another state, he or she should check the specifics for that state.
Emily Duncan, student health insurance coordinator at the University of Kentucky, has posted a blog that lays out the specifics of the Affordable Care Act and explains some options for Kentucky students. Read it at Ukhealthcare.uky.edu/UHS/healthcare-reform-students.
One group thinks the health exchanges might not be the best place for people to buy insurance. Generation Opportunity, a conservative group funded by the Koch brothers, is using provocative, and some say misinformation-filled ads, to tell young adults to diss the reforms.
"We are not advocating young people go without insurance," said David Pasch, the group's communications director. "There are plans available on the private market that may be better. I think young people should look at all health care options available to them if they are going to make the smart decision."
Obama tried to appeal to some of the younger generation, telling 2,000 students at Prince George's Community College this month that they could sign up for coverage as easily as buying "a TV on Amazon."
Staff writer Mary Meehan contributed to this story.