Supreme Court decision on federal health care law could fire up young voters - Plain Dealer

WASHINGTON, D.C. - Lauren Burr has only a couple of weeks left as a college student.

Then, after graduating with a bachelor's degree in education from Ohio University, she'll move back in with her parents in Perry and look for substitute teaching jobs until she finds a long-term position. Subbing has no fringe benefits, but Burr, 23, can count on having health insurance through her father's plan at work.

Or so she hopes.

Like other graduating seniors, Burr joins a cadre of young Americans who lack jobs and rely on President Barack Obama's signature achievement, known by all sides as Obamacare, for their health care. Young adults who lack health insurance are assured of coverage under their parents' plans under the Patient Protection and Affordable Care Act of 2010. By the end of 2011, 2.5 million young adults -- 81,922 of them in Ohio -- had obtained coverage that way, the White House says.

But the U.S. Supreme Court could strike down the health care law when it rules on a constitutional challenge, probably in June. The law is unpopular in Ohio, polling shows, and Ohio voters have already said through a ballot initiative that they want to invalidate its mandate for nearly everyone to get health insurance.

Yet its proposed cancellation has the potential to anger young adults, an important voting bloc for Obama in November.

Young voters helped elect Obama in 2008, but their enthusiasm for the Democrat has waned somewhat since then, a result of liberal disappointment with the slow pace of change and a likely overall disappointment with the economy, says Peter L. Levine, an authority on youth voting who directs Tufts University's center on civic learning and engagement.

"A Supreme Court decision could draw attention to what the health care reform means to young people tangibly and thus strengthen support for the president," Levine says.

Former Ohio Gov. Ted Strickland, a national co-chairman of the president's re-election campaign, says this is a "very significant issue, because these kids are getting out of college and some of them are not going to have jobs."

Although the Bureau of Labor Statistics does not have data limited only to recent college graduates, the current national unemployment rate for people under age 25 is 16.4 percent, or more than double the rate for the general population.

Without the health care law, this group could lose coverage under their parents' plans, "and it's impossible to be able to afford an individual policy unless you're a wealthy or semi-wealthy person," Strickland says.

Just knowing that she could be covered under her father's plan has been "awesome," Burr says, recalling how her sister, now 29, went six or seven months without coverage and was always nervous about getting sick. Burr says she rarely goes to the doctor, but "it's scary to think of, a few months or years of going without insurance, and if something happens. . . . There's that luck of the draw where you get in a car accident or you fall down the stairs and you break your leg."

That alone, she says, "could sway young adults to vote in favor of Barack Obama."

GOP says law imperils jobs

Until the Affordable Care Act came along, most employer-provided plans kicked workers' dependents off when they reached 18 or 19 or were no longer full-time students.

The changes provided comfort to Angie Giallourakis, of Westlake, whose 21-year-old son, Steven, is a two-time cancer survivor. Diagnosed for the second time while a student at John Carroll University, he was covered on his parents' insurance as long as he was in school full time.

The rigors of a bone marrow transplant and recovery made it hard to continue as a full-time science student, and Steven became an art student at the Cleveland Institute of Art. Then Obamacare's young-adult provision assured him of insurance coverage regardless of his enrollment status or insurance risk.

"We were able to take some of the pressure off Steve and let him go to school part time if he wanted to," his mother says. He's now transferring to Cleveland State University, to return to a science major, ideally physics.

Critics of the law, including many Republicans, say they understand the need to help patients with chronic conditions and young adults. They say they would offer legislation with many similar features, although Democrats say the GOP failed to pass anything similar before.

Their primary complaint is that the law intrudes into individual rights by requiring nearly all Americans to get health insurance or pay fines.

The Supreme Court could leave the law intact, strike down the mandate or strike the entire law. Republican presidential candidate Mitt Romney and congressional Republicans say they want to repeal the law if the court doesn't.

Asked about possible backlash from young adults, Romney's campaign points to the fact that so many students are graduating without jobs. Obama's economic policies are to blame for that, the campaign says, and the health law is making matters worse.

Romney spokesman Christopher Maloney lists fast-food chain White Castle, headquartered in Columbus, Mound Laser in Miamisburg and Elyria-based Invacare as examples of companies that could be financially penalized because of new taxes and fees in the health care law. These and other companies say that could affect their ability to hire.

As a result, Maloney says, "it's clear that the president's health care law only serves to imperil" employment prospects for people in their 20s.

At Franciscan University of Steubenville, there is another kind of backlash over the health care law. The Catholic university has told students it will stop offering them health insurance this fall because it objects to the law's mandate to offer coverage for "contraception, sterilization and abortion-causing medications."

In addition, the university told students, the law increases the mandated maximum coverage for student policies, "which would effectively double your premium cost."

Obama's campaign takes a very different position on the impact of the law.

"Today, thanks to Obamacare, tens of thousands of young Ohioans who would have otherwise been uninsured now have health care coverage because they can stay on their family plans," says Obama campaign spokeswoman Jessica Kershaw.

"Repealing the health care law like Mitt Romney wants to do would put insurance companies back in the driver's seat and take new rights and protections away from thousands of young Ohioans, who are, no doubt, now relieved they don't have to worry about affording health insurance while getting a jump-start on their lives."

State law has loophole

While Congress was debating health care, the Ohio legislature and then-Gov. Strickland passed their own, state-based insurance reforms to help young adults. Under state law, uninsured adults can stay on their parents' plans until they turn 28. That's two years longer than under Obamacare.

The Ohio law, however, has a big loophole.

Private-sector health plans are exempt from the state law if they are self-funded, explains Ethan Vessels, an attorney in Marietta. Self-funded plans are those in which the employer pays the doctors, hospitals and labs when the bills come in. Employees usually have no idea that this occurs, because most employers hire a third party -- usually an insurance company -- to administer their claims.

Sixty-six percent of Ohioans who are insured through employer-sponsored health plans -- 4 million out of 6 million people covered by employer plans in Ohio -- are in self-funded plans, according to a study commissioned by the Ohio Department of Insurance. The bigger the employer, the higher the chances that the health plan is self-funded, according to the Kaiser Family Foundation.

That means a family could lose Obamacare's protections and, to its surprise, not have state protections to fall back on.

This has practical and political implications. A Supreme Court decision in June would come in the middle of a policy year. Companies that provide insurance to their employees are unlikely to change their policies until it's time for renewal, typically around the end of the year, say insurance and employment-law authorities.

So young adults on their parents' plans might have a short reprieve, at least. But they could have a long-term one, too, says Robert Klonk, president and chief sales officer at Oswald Cos., a Cleveland-based insurance brokerage and adviser.

After all, "employees love the benefit," Klonk says. Would employers really want to take that away, kicking adult children off the plans?

"I think that now that employers have already done that, they're not going to take it away," he says.

Obama needs the youth vote

The political implications are more complex. Republican lawmakers in Washington, including Rep. Jim Jordan, an influential conservative from Champaign County in Ohio, say there is GOP support to keep some features of Obamacare, including the one covering adult children. Jordan points to a proposal by Republican Rep. Tom Price of Georgia, a former orthopedic surgeon. Price's bill would remove the mandate but provide alternatives, including a high-risk medical pool for people with pre-existing conditions.

But this and similar GOP alternatives include additional features that many Democrats dislike, including caps on medical malpractice lawsuits and restrictions on abortion coverage. In an election year in which Congress cannot agree on ways to finance student-loan interest rates and domestic-violence shelters, new health care legislation could face long odds.

And that alone means a political fight that extends to the presidential election.

Obama needs to coalesce the youth vote. Young adults flocked to Obama during the 2008 race but their level of intensity has dropped, creating a turnout challenge this year. Obama's reelection team acknowledged the importance of the youth vote by kicking off his campaign May 5 with rallies at Ohio State University and Virginia Commonwealth University.

A loss of health benefits could turn up the youth intensity. On the other hand, cautions Levine, conservative youth turnout was so poor in 2008 that "Romney has room to improve his showing, not so much by persuading young people to switch allegiance but by energizing conservative young people."

He also notes that neither health care nor college tuition motivates young people "the way Social Security and Medicare move seniors." They are less organized, more diverse in their life circumstances, and "they pass through young adulthood relatively quickly. So no single issue has an overwhelming impact on youth voting."

Strickland, too, says the issue could play to either side, depending on what the Supreme Court does.

If the court strikes down Obamacare, he says, "it could really energize the left."

"On the other hand, if the court allows it to proceed, that could be one more energizing factor on the right. Regardless of what happens, it's bound to have some political impact."

Plain Dealer Reporter Sabrina Eaton contributed to this story.

20 May, 2012