Lindsay Kline ignored the throbbing pain in the side of her face for days, until it became unbearable.
At 22 with a job as a waitress and no health insurance, Kline couldn't afford a trip to the doctor.
But when she began vomiting uncontrollably and the swollen area on her face "looked like a softball," Kline went to the emergency room.
Doctors in the ER told her an untreated abscessed tooth sparked a systemic infection that could have killed her if she had waited much longer. After spending a night in the hospital undergoing expensive treatments including MRI and CT scans, Kline was released the next day.
"They had to do a lot of things because I was at such a dire point," said Kline of Tulsa.
That trip to the ER and other medical bills piled up over the next year until Kline was forced to file bankruptcy at age 23. Her medical bills totaled more than $18,000.
"I wasn't a shopaholic, and I hadn't bought a car," said Kline, now 29. "My credit was ruined at a young age."
In the continuing national debate over the Affordable Care Act and health care, many pundits have dubbed 20-somethings such as Kline the "young invincibles." Many in this demographic won't sign up for insurance - as required by the law's "individual mandate" - because they feel largely immune from the risk of being uninsured.
'$50 a month didn't buy much'
Karen Pollitz, a senior fellow with the nonprofit Kaiser Family Foundation, is quite familiar with the notion of "young invincibles" who believe they don't need insurance. And she doesn't buy the logic.
"I personally get a little irritated by it," said Pollitz, who said she is also the mother of a young adult. "My young invincible son knows better."
A popular prediction among critics of the sweeping health-care overhaul is that a lack of participation by young adults in the law will bring down the whole system. Pollitz notes that, financially, the Affordable Care Act doesn't rely on premium payments by the young.
"It's really based on everybody. The young don't pay as much. For the same policy, I'm going to pay up to three times what a young person is going to pay."
Pollitz said the notion that many young adults reject the need for health insurance because they feel invincible may be due to some insurance industry practices.
"I think the insurance industry for a lot of years has tried to justify the way they rated policies," she said.
Companies sold cheap policies to young adults who later dropped them because "$50 a month didn't buy much health coverage," she said.
'Happy birthday, you are uninsured!'
Pollitz said young people do want insurance, as shown by a recent Kaiser Foundation poll. Of those polled between ages 18 and 25, more than 75 percent agreed having health insurance is "very important," is "worth the money it costs" and is "something I need."
Overall, four in 10 young people cite cost as the biggest barrier to insurance, the foundation's poll found.
Young adults polled were about twice as likely as adults of all ages to believe they were healthy enough to forgo insurance. About 24 percent of those from 18-25 agreed with that statement.
The average age of all people without health insurance skews young due mostly to insurance policies that dropped adult children, Pollitz said.
That practice was common before the Affordable Care Act's 2010 requirement kicked in, allowing parents to keep children on their insurance policies until age 26, she said. The change in federal law covered 3 million young adults who would have lost health insurance.
"Happy birthday, you are uninsured!" Pollitz said. "We kicked them off their parents' policy as soon as they turned 19 or a little bit older if they were in school. As soon as you walk across the stage and get your diploma, oops, you are out of insurance."
'Just for catastrophes'
Pollitz said many young adults do harbor misunderstandings about health insurance. They should know that uninsured people are charged far more for even routine procedures than those with insurance, she said.
"There's a prevalent notion that health insurance is just for catastrophes. But medical bankruptcy for most people is less than $10,000," she said. "They don't have it in the bank, and the hospital expects to be paid."
Kline is all too aware of that fact, acknowledging she should have tried to negotiate with the hospital over the bill.
More than five years after she filed bankruptcy, Kline's medical bills have stacked up again, due mostly to her jaw disorder. The disorder of the joint joining the upper and lower jaw bones - known as temporomandibular joint - causes sharp, chronic pain that radiates through her head, neck and shoulders.
A car wreck when Kline was pregnant with her daughter Lola, now 4, "was another massive bill." She escaped serious injury but required more expensive tests because doctors wanted to be sure Kline and her unborn child weren't harmed.
'Huge relief'
Health problems and the financial fallout have also taken their toll mentally. Sometimes, Kline struggles with anxiety and depression.
A $700 medical device her doctor prescribed to alleviate the symptoms of TMJ should be routinely adjusted in order to work properly as she sleeps. Kline can't afford to pay for the adjustments, making the device less effective.
Her parents helped to pay medical bills when possible but couldn't afford to pay for all of Kline's expensive care. A root canal recently cost Kline more than $1,000, a cost she split with her mother.
Kline knows she needs insurance but hasn't been able to afford it while paying rent, buying food and trying to pay off existing medical bills.
"I feel like a lot of the health problems I've had are because of a lack of preventative care. ... Usually I only go because I feel like I absolutely have to."
Kline is now two months away from finally having health insurance through her job as a recruiter at a staffing firm.
"It will be a huge relief because I will be able to do the preventative care, but it's not going to solve everything."
Pollitz said Kline's story points out another reason young people should be insured, whether through the Affordable Care Act - which begins enrollment Oct. 1 - or an employer-sponsored plan.
"We, the mothers, worry about them. And if, God forbid, something big happens, we will mortgage our house, we will empty our 401(k). They are not just risking their own finances - it becomes a family affair."
Young adults and health care
Nationwide, 30 percent of young adults lack health insurance, the highest rate of any group. One in five of the uninsured are young adults.
The rate is three times higher than the uninsured rate among children.
Source: U.S. Dept. of Labor
Ziva Branstetter 918-581-8306
ziva.branstetter@tulsaworld.com
Original Print Headline: Health law offers options
