FRIDAY, May 30 (HealthDay News) -- The number of young adults without health insurance rose again in 2006, so 38 percent of high school graduates and 34 percent of college graduates will spend some time uninsured in the year after graduation, a new report shows.

"We've been tracking this since 2003, and every year we've done the study, the number of uninsured has grown," said report co-author Sara Collins, an assistant vice president at the Commonwealth Fund.

There were 13.7 million Americans aged 19 to 29 without health insurance in 2006, up from 13.3 million in 2005, according to the latest federal data, the report said.

"There are a couple of transition periods when you turn 19," Collins said. "Many health insurance programs won't cover you as a child, and also when you graduate from college."

Public programs such as Medicaid and the State Children's Health Insurance Program end coverage at the age of 19. "Voluntary employer-provided insurance is tied to the ability to get a job, and the jobs available to young people tend to be those that don't carry benefits," Collins said.

While young people are less likely to need health care, "they do use the health-care system," she said. "Losing coverage at this time can affect your ability to transition effectively into a situation of health care."

And when young people do require health care, it can be because of a major accident, in which costs can be "catastrophic," Collins said. "And it is never a good idea to be without health insurance, no matter what your age."

Two-thirds of the young adults who went without health insurance for some time went without needed care because of cost, the report said. Half reported problems paying medical bills or said they were paying off medical debts over time.

Some action is being taken to remedy the situation, Collins said. Twenty states have passed legislation requiring insurance companies to extend coverage of minors after age 18 or 19. The age limits in state laws range from 24 in Delaware, Indiana and South Dakota to 30 in New Jersey.

On the federal level, a law has been proposed that would have dependent children of government workers covered to age 25.

Extending the age limit for federal programs such as Medicaid would have the greatest impact, because such programs cover poorer people, Collins said. "This is a problem facing people at all income levels, but the largest number of uninsured are in lower income families," she said. Raising the age limit for those programs would cover up to 7.6 million uninsured young adults in families with incomes below 200 percent of poverty, the report said.

States could help by having the colleges and universities that they fund offer insurance to students, both full time and part time, the report said.

The issue calls for a public-private approach, said Robert Zirkelbach, spokesman for America's Health Insurance Plans, a group in Washington, D.C., that represents 1,300 insurers covering 200 million Americans.

The organization has made several proposals about better coverage for younger adults, including expansion of Medicaid to cover all members of a family, Zerkelbach said.

"We need to make health-care coverage more affordable," he said. "That has to be done by reducing the underlying costs of medical care."

More information

Learn about Medicaid and the State Children's Health Insurance Program from the Centers for Medicare & Medicaid Services.

SOURCES: Sara Collins, Ph.D., assistant vice president, Commonwealth Fund, New York City; Robert Zirkelbach, spokesman, America's Health Insurance Plans, Washington, D.C.; May 30, 2006, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help

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