Getting young, healthy people to sign up for health insurance is seen as critical to the success of the Affordable Care Act. It's precisely those people who will help offset the cost of the older, sicker ones.
But while cheap health insurance and subsidies based on income are intended to make the program appealing to the young, what if they haven't even heard of the health care law? Or don't want to buy even an inexpensive policy?
To find out, I needed to find groups of those young, healthy people. I live in Hollywood, so where better to look than a casting agency?
I met Matt Rife, a comic, at the Cazt agency's open call for a comedy show. Rife, 18, works at comedy clubs and doesn't have health insurance. But he does need it, he says.
"Like, if I get hurt, I'm kind of screwed," he says. "If I get sick, I'm on my own — I'm down to some ibuprofen and some cough drops and that's about it."
Rife says he and his friends don't talk much about health care because it seems like a distant political thing that doesn't have much to do with them.
"We're worried about it, but not, like, 'Oh, we gotta get this today or we're going to be in trouble,' you know."
If something did happen, Rife says, having insurance would be nice. But he admits he'd like to buy a car first.
Blake Sheldon, 21, is also here for an audition. He works at a sandwich shop when not looking for acting gigs and is uninsured. He hasn't thought much about the Affordable Care Act, he says.
"What I do know is that it doesn't seem too easy right now, at least, from my understanding," Sheldon says. "And so with, you know, all the other stuff going on in my life, moving out here — I don't know. I guess I just haven't done that much research into it."
In fact, a lot of the young people that I talked to didn't seem aware of the Affordable Care Act and how it related to them in any great detail — though there have been some marketing attempts to reach out to them.
Carrie Prince, 28, is a freelance production assistant for a major Hollywood studio. And while she works more than 40 hours a week, she doesn't get insurance from her employer. She's going to buy coverage, she says, but she's torn about it.
"It will make me broke all the time," she says. "It's basically taking every last dollar that I would have to spend on extra food, or a parking ticket or anything."
Prince says she's gone to HealthCare.gov and calculated that with a subsidy she would have to pay just over $100 per month.
"I am super-healthy. I rarely go to the doctor. So to pay over $100 a month for something I rarely use seems crazy to me," she says.
Over at The Bar Method, a small health club in Long Beach, Calif., Aubrey Castle-Saunders teaches a workout that's a cross between Pilates, yoga and 1980s aerobics. She's 29 and doesn't have health insurance right now.
Up until last year, she says, she would rather have paid a penalty than buy coverage. She's healthy and takes care of herself, she figured. But then she got kidney stones.
"And it was completely out of the blue, and the bill was astronomical," she says — and the pain was unbearable, too. That was a wake-up call, Castle-Saunders says. She's gone to HealthCare.gov to look at the plans, but even now she's not 100 percent sure she's going to enroll.
"I really do want to sign up. And I most likely will," she says. "But it's just kind of like, oh God, OK, I have to put ... that money out there. So I really am dragging my feet."
The administration can't afford much of that feet dragging, however — it needs millions more like Castle-Saunders to sign up.
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For all the difficulties the Affordable Care Act has faced so far, many people are still optimistic it will be successful. But to clinch that success, a very important demographic has to participate: young, healthy people. After all, it's the young, healthy people who will help offset the cost of the older, sicker ones. And in order to appeal to the younger set, the health care exchanges are offering inexpensive health insurance.
But what if those youngsters haven't heard of the health care law? Or what if they don't want to buy even a cheap policy? NPR's Sonari Glinton sought out some young and uninsured people to find out.
SONARI GLINTON, BYLINE: I was trying to figure out where could I find groupings of young, healthy people. And I thought, ha, I live in Hollywood, might as well come to a casting agency. I'm here at the Cazt - that's with a Z - agency in West Hollywood, and there's an open call for a comedy show, and hopefully I'll find some young and maybe funny actors without insurance.
MATT RIFE: Oh, my name is Matt.
RIFE: Rife, R-I-F-E.
GLINTON: And you're an actor.
RIFE: A comic.
GLINTON: Rife is 18. He's working at comedy clubs. He doesn't have health insurance, in part because things aren't going so great back at home with his parents. But he says he needs it.
RIFE: Like, if I get hurt, I'm kind of screwed, you know? Like, if I get sick, I'm on my own. Like, I'm down to just, like, some ibuprofen and some cough drops. And that's about it.
GLINTON: Rife says he and his friends don't talk much about health care because it seems like a distant political thing that doesn't have much to do with them.
RIFE: We're worried about it but not like, oh, we got to get this today or, like, we're going to be in trouble, you know, just as a precautionary thing.
GLINTON: It'd be good to have...
RIFE: Yeah. If something did happen, it would be nice, you know?
GLINTON: You want your car first.
RIFE: Yeah. I would like a car first.
GLINTON: Meanwhile, going up for the same part is Blake Sheldon. He's 21 years old. He works at a sandwich shop when he's not looking for acting gigs. He doesn't have insurance, and he doesn't know very much about the Affordable Care Act.
BLAKE SHELDON: What I do know is that it doesn't seem too easy right now, at least from my understanding. And so with all the other, you know, stuff going in my life, moving out here just - I don't know, I guess I just haven't done that much research into it.
GLINTON: A lot of the young people that I talked to didn't seem aware in any detail of the Affordable Care Act and how it related to them. There have been some marketing attempts to reach out to them.
(SOUNDBITE OF PHONE RINGING)
CARRIE PRINCE: This is Carrie.
GLINTON: I called Carrie Prince at work. She's 28. She's a freelance production assistant in Hollywood. She works full time, more than 40 hours a week for a major studio, but she doesn't get health insurance. Though she's heard a lot about health care, she says she's going to get it but she's still torn about it.
PRINCE: It will make me broke all the time. All the time. Like, it's basically taking every last dollar that I would have to spend on extra food or a parking ticket or anything.
GLINTON: Prince says she's gone on the website and calculated what she'd have to pay: just over $100 a month, and that's with a subsidy.
PRINCE: I am super healthy. I rarely go to the doctor. So to pay over 100 bucks a month for something that I rarely use seems crazy to me.
(SOUNDBITE OF MUSIC)
AUBREY CASTLE-SAUNDERS: All right. Lift your chest. Place your hands on your waists. Pull your abs in. Press your shoulders down. Start to lift your knees. Up. Up. Up.
GLINTON: This is a small health club called The Bar Method on Pacific Coast Highway in Long Beach, California. The workout is a cross between Pilates, yoga and 1980s aerobics, if you can imagine that.
CASTLE-SAUNDERS: OK. Your body warms up for the rest of the class. Bring your arms higher.
GLINTON: The person we've come to see here is the instructor, Aubrey Castle-Sanders. She's 29, and she doesn't have health insurance now.
CASTLE-SAUNDERS: Up until last year, I think, had you been like, oh, you're going to have to pay a penalty, like, if you don't purchase it. There would have been no doubt in my mind, I would've been, like, I'm not purchasing it. I'm healthy. I take good care of myself. But I got kidney stones last year, and it was completely out of the blue, and the bill was astronomical.
GLINTON: Not only were her bills astronomical, but she says the pain from the kidney stones was unbearable. And that was a wake-up call. She's gone on HealthCare.gov to look at the plans. But even now, she's not 100 percent sure that she's going to sign up.
CASTLE-SAUNDERS: I really do want to sign up and I'm like - I most likely - it's like I most likely will. But it's just kind of like, oh, God. OK. I have to, like, put up this like - I have to, like, put that money out there for that. So I am kind of dragging my feet.
GLINTON: The administration can't afford to have that feet dragging. It needs millions more like Castle-Saunders to sign up. Sonari Glinton, NPR News, Culver City. Transcript provided by NPR, Copyright NPR.