Tyler's Story

This is the first of a 6 week series entitled, "Summer at the County Fair".  It is a synopsis of 6 hours I spent meeting and speaking with people who were visiting a county fair in western PA.  Over the next few weeks you will see the human faces that mirror our national statistics regarding the uninsured and underinsured.  Thanks to the Pennsylvania Health Access Network (PHAN) for their assistance in this series.

Artwork by: Don Perino

Early afternoon at a county fair has a flavor of resurgence.  Clean hay in the stables, tidied sidewalks, vendors opening their panels.   With the sun high in the sky, the rejuvenated crowds begin to dwindle in.  All is fresh and ready for a new day.  Just before his shift at the steak sandwich concession, I met Tyler, a blond-haired 22 year old from Venango County, PA.  Behind his timid approach, Tyler’s captivating blue eyes and shy smile told the eternal tale of youth and hope.  His image portrayed someone ready to embrace the future, but was in fact disguising an old soul. 

 While other 22 year olds were out relishing in the immortal fruits of youth, Tyler was talking about health insurance.  He has been uninsured for over 4 years, since he turned 18.  His employer does not offer health insurance and for Tyler, a full time worker, it is simply unaffordable on an income of $17,000 a year.  Most young people in Tyler’s situation opt to take their chances and just go without health care and insurance.  Tyler on the other hand does not see his health and financial security as a viable gambling chip.  This reality recently became apparent to him when he witnessed an uninsured friend have an emergency appendectomy leaving him with an $8000 bill, or otherwise stated, a half year’s salary for Tyler!

Where does someone like Tyler go?  He describes himself as being in a losing situation, and he appears to be right.  Explore his options:  Medicaid-no, he’s not poor enough.  Medicare-no, he’s not old enough.  CHIP- no, he’s too old.   VA-no, he’s not a veteran, Pennsylvania’s Adult Basic Program-no, the program was recently eliminated.  Employer provided care-no, they do not offer insurance and they are not obligated to.  The walls of our dysfunctional health insurance system have closed in on Tyler and left him trapped.  As our youth run into one roadblock after another, it makes me question how much we value our future.  Of those that are uninsured, 40% are between the ages of 18-34.[i]  How can we expect our future innovators, entrepreneurs and leaders to grow our economy and lead us into the 21^st century when we give them no viable options for meeting their most basic needs?  Where is our investment in the future?

The Patient Protection and Affordable Care Act will now break down the roadblocks our dysfunctional health insurance market has created for our youth.  For many young people, they have the option of staying on their parent’shealth insurance until they are 26.  Unfortunately, for Tyler, this is not an option because his parents are also uninsured.  Thankfully there are still other alternatives for people like Tyler that do not get employer provided health care.  In 2014, Tyler will have access to the individual exchanges, a marketplace where individuals will pool together in order to purchase insurance and lower the costs.  Additionally, because of Tyler’s income, he will qualify for a premiumtax credit that will ensure that his monthly premiums will not exceed roughly 4% of his income.  In 2014, it will also be harder for employers like Tyler’s to get away with not providing health care because there will be a $2000 fine if they do not provide health care and their employee’s receive subsidies in order to purchase on the exchange.  Tyler can also expect to enjoy the other standard benefits guaranteed by the Patient Protection and Affordable Care Act such as preventivecare, medical loss ratio, basic patient protections and ratereview.

Tyler’s optimism refused to be weighed down by the gravity of his current situation because he too was looking into the future.  As he hurried back to work for the anxious lunch crowd, he knew that there was hope in sight for his generation.  The many roadblocks he had encountered over the past 4 years were beginning to crumble and he and his peers would now have the tools to drive us down that road.

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[i] Source:  KCMU/Urban Institute Analysis of 2009