This story continues the Gazette's coverage of the impact of health-care reform on West Virginia. For an overview, go here.
CHARLESTON, W.Va. -- On weekends, Tiffany Little, 25, serves lattés and scones at Charleston's Taylor Books. During the week, she works with disabled people. Zion Godfrey, 25, is looking for a job as a researcher in Middle Eastern studies when he isn't running the register at the bookstore.
Like 73,000 other West Virginians between 19 and 29, they have no health insurance. "Insurance is completely unaffordable to me now," Godfrey said. "I have two degrees, but I just don't go to the doctor."
Most of the 14 part-timers at the bookstore are in school, looking for jobs in their field, or making extra money. "Thank goodness for Taylor Books," Godfrey said.
Part-time clerk Chris Rodgers, 21, will lose insurance coverage as soon as he graduates from West Virginia State University. "I don't worry too much about it," he said. "I just hope nothing happens."
Taylor's customer John Michael of Asheville, N.C., used to feel that way. At 30, the Roane County native has his own Internet business, but no insurance. Recently, his wife developed a brain aneurysm, he said. "I used to think, well, I'm young, so maybe I won't need insurance," he said, "but now we're talking with the hospital about charity care, and we're not sure what will happen."
Thirty percent of young West Virginians between 19 and 29 have no health insurance, the largest percentage of any age group, according to advocacy group Families USA. Many work part time, go to school or have low-wage second jobs.
If Congress passes a health reform law, they will all be required to have insurance or pay a penalty. "I don't think I can afford the insurance," Rodgers said.
Under the bills on the table, four new options would make insurance more affordable for anyone who makes less than $43,000 per year:
If they are over 18 and make less than $14,400, as many students do, they would be eligible for Medicaid insurance. Under present law, West Virginians over 18 are not eligible for Medicaid unless they make less than $3,700 per year, one of the lowest income limits in the nation.
If they make between $14,400 and $43,000, they could get subsidies for their insurance premiums.
Insurance companies must let them stay on their parents' insurance as dependents until they are 26 or 27, with their parents' OK. That takes effect as soon as the law passes.
The Senate bill includes a "young invincible" provision that lets young people buy low-cost catastrophic insurance with a high deductible to protect them against financial disaster in case they need high-cost medical care.
The subsidies and Medicaid expansion would start in 2013 or 2014, depending on what date ends up in the final bill.
A House-Senate conference committee, including Sen. Jay Rockefeller, D-W.Va., will hash out the final proposal soon.
Tiffany Little urges them to remember the young people. "I have two jobs, and I have Medicare taken out of both my checks, but I can't get Medicare," she said. "I want to help the seniors, but I want the younger to be able to get care when we need it too."
She looked over a schedule of subsidized premiums that would be available to a single person under the Senate bill.
For a policy that ordinarily costs $3,500, a person earning $15,000 would pay $622 a year.
A person who makes $20,000 would pay $1,153.
If a person earns $30,000, he or she would pay $2,699.
At $35,000, a person would pay $3,430.
"I could actually do this, if that's what it ends up being," she said.
Customer Chandler Runyon, 24, had the same reaction. "A lot of West Virginians can't come close to affording insurance now," he said. "That, they definitely could afford."