A dependent adult.

It was October of my freshman year at Penn State University, and I awoke in a panic. The pain seared across my lower back and wrapped around my hips. I tried to get out of my bed and found that the pain was so intense that any time I moved my legs, I felt as though I was being stabbed in the back. I yelled across the room to wake my roommate. She called my brother, a senior at Penn State at the time, and he immediately picked me up at my dorm and took me to the hospital.

It took a full week, three doctors, multiple X-rays and an MRI before I was diagnosed with desiccated and herniated discs throughout my lumbar spine. At just 19 years of age, my spine looked more like someone three times older. In order to regain basic movement, I needed physical therapy every day for three months. Thankfully, at this point in my life I was covered by my mother's insurance. While I couldn't believe how quickly the co-pays piled up, I didn't realize how much worse it could be--until the following year.

The next August, right before my sophomore year, my mother and I sat in our living room trying to decide whether I should stay on her insurance plan or buy my own coverage through Penn State. It had been 10 months since my back gave out. In that time, I'd completed hours of strenuous physical therapy and was slowly extending my range of motion. My mother and I decided that purchasing my own insurance through Penn State would be less expensive for us, and was the better choice. In retrospect, we should have taken the residual effects of my injured spine more into consideration when making this decision. Buying insurance through my university turned out to be a huge mistake that I ended up paying for, literally.

Only two months into my sophomore year, my doctor ordered an MRI of my thoracic and lumbar spine to check on my progress. The next day, the doctor's assistant called me to say she could not confirm that my Penn State insurance carrier would cover this MRI; she said I needed to contact my insurance company directly to ensure the MRI would be approved. After several attempts to speak to an insurance representative, I was told that my insurance could only cover an MRI if it was both performed at a covered location and read by a covered physician. Is there a MRI facility in the Philadelphia area that has physicians to read the report that are covered by my insurance? No. Then how can I ensure that the physician who reads my MRI is covered by my insurance? No answer.

Because I was in so much pain and needed answers about what was going on with my back, I decided to schedule an MRI at my local hospital, which was a covered provider with the insurance company, and which had a covered physicians on staff. I arrived on the day of my MRI and asked the woman at the sign-in desk how I could ensure that the physician covered by my insurance would be the one to read my MRI. She told me that it was impossible to guarantee who would read the MRI. Further, she said that, if I got the MRI, I risked my insurance company refusing to pay for the procedure if a non-covered physician read the MRI. Oh, and that an MRI costs thousands of dollars, which I would be responsible for if the insurance company denied payment. As a college student and child of a one-income home, I had no choice. I canceled the MRI and walked out of the hospital.

After another round of talks with my mother, we decided to wait to get the MRI until she had enrolled me in her insurance plan, in November. Until then, physical therapy would have to do. I attended physical therapy daily and the pain lessened, but I wondered if I was making any real progress. Were my herniated disks sliding back into place between my vertebrate? I finally had an MRI performed in January. As it turned out, my spine looked exactly as it did when I was initially diagnosed. Physical therapy helped manage my pain but could not correct the damage that was already done.

Now, thanks to the Affordable Care Act (ACA), I can stay on my mother's insurance through college and graduate school. Starting in 2010. the ACA allowed dependent children to stay on their parents' insurance plan until age 26. (1) Before this, adult children could be dropped from their parents' insurance because of age, regardless of whether they were in school or where they lived. (2) If not for this provision of the ACA, after college I would be forced to, once again, get my insurance through the university I attend for graduate school. I learned the hard way that, for people with chronic and pre-existing medical conditions such as myself, this insurance option can be very limiting (and can be very frustrating at that!).

Still, I am luckier than many other young people. As a college student, I was eligible for coverage through my college, even if that coverage was subpar. Many young adults either choose not to pursue a college degree or do not even have the opportunity to do so. Many of my cousins joined the workforce after graduating from high school and worked in jobs that didn't provide them with health insurance. For example, when my cousin Chris (not his real name) graduated from high school, he wasn't sure what he wanted to do next. He decided to take a job building houses for a construction company. Obviously, working in construction can be very dangerous. In fact, the rate of fatal injury in the construction industry is higher than the national average for all industries. (3) Chris' construction job was temporary and did not provide medical insurance. This was very risky considering the job's inherent danger, but there was no way Chris could afford private health insurance on his own. He had to go without any insurance.

According to the Department of Labor, only 68.1% of people who have graduated from high school enroll in college. (4) This leaves 31.9% of high school graduates without the opportunity to receive medical insurance through their universities. The Affordable Care Act provides increased access to health insurance to Americans, like my cousin, who work high-risk jobs that do not provide health insurance. Before the ACA, my cousins and other Americans who did not go to college would have joined the ranks of the approximately 30% of young adults over age 18 who were uninsured. (5) While the ACA is a step in the right direction, we still have a long way to go because this provision of the ACA only benefits young adults whose parents are themselves insured.

Being able to remain on our parent's health insurance until the age of 26 directly improves the lives of younger adults. Being covered by my mother's insurance allows me to receive effective and efficient medical care for my spinal condition now and through the end of graduate school. As an adult with a serious medical condition, no insurance and poor health care are not viable options if I am to remain healthy and fit. The ACA helps both students, like me, and young adults in the workforce, like my cousin. This year, under my mother's insurance, I was able to make one phone call and schedule an approved MRI. A miracle? No. Just the Affordable Care Act doing its job.

REFERENCES

(1) U.S. Dept. of Health & Human Services (HHS), "Young Adult Coverage," Washington, DC: HHS, March 23, 2009. Retrieved 10/17/11 from http://www.healthcare.gov/law/features/choices/young-adult-overage/ index.html.

(2) U.S. Dept. of Labor (DOL), "Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Businesses and Families," Washington, DC: DOE no date. Retrieved 10/17/11 from http://www.dol.gov/ebsa/faqs/faq.dependentcoverage.html.

(3) DOL, "Occupational Safety & Health Administration." Washington. DC: DOE no date. Retrieved 11/13/11 from http://www.osha.gov/Publications /OSHA3252/3252.html.

(4) DOL Bureau of Labor Statistics, "College Enrollment and Work Activity of 2010 High School Graduates," Washington. DC: DOL, 2011. Retrieved 11/13/11 from http://www.bls.gov.news.releas/hsgec.nro.htm.

(5) Centers for Medicare & Medicaid Services' (CMS) Center for Consumer Information & Insurance Oversight, "Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses", Washington, DC: CMS, no date. Retrieved 10/18/11 from http://cciio.cms.gov/resources/files/ adult_child_fact_sheet.html.

Jacqueline Plunkett will graduate from Penn State University in May with a degree in Communication Arts and Sciences: Rhetoric. she will begin la,, school in Fall 2012 to pursue a career in human rights law.