The success of the new health-care law rides in large measure on whether young, healthy people like Gabe Meiffren, a cook at a Korean-Hawaiian food cart, decide to give up a chunk of disposable income to pay for insurance.
After getting a peek at rates being offered for fall, the 25-year-old man said he would have to peel back "expenses that aren't life or death, like records and concert tickets," or whiskey sours at the Horse Brass Pub down the street.
Mr. Meiffren, who hasn't seen a doctor in more than a year, isn't sure buying insurance is worth it, despite a federal penalty for failing to buy coverage, starting in January.
President Barack Obama's signature initiative rests on what Mr. Meiffren and his peers choose. If flocks of relatively healthy 20- and 30-somethings buy coverage, their insurance premiums will help offset the costs of newly insured older or sicker people who need more care. If they don't, prices across the U.S. could spike.
Traditional insurance industry tools for managing risk—such as charging sick customers higher prices—are banned under the law, raising the importance of attracting young, healthy buyers.
The new law employs a carrot-and-stick approach: Federal subsidies will be available to some lower-income workers. And most of those who ignore the law next year must pay an annual penalty, based on income, that begins at $95 and climbs dramatically in the years that follow.
Interviews here with more than two dozen single workers of modest income between 24 and 31 years old suggest that insurance plans will be a hard sell. Subsidies for 26-year-old workers range from $118 a month for someone earning under $16,000 to less than $1 a month for one earning $26,500, according to an analysis of insurance data.
For Mr. Meiffren, the cheapest available insurance plan he could buy with the subsidies would cost him $116 a month, with a $6,350 annual deductible. His subsidy would total $14 a month, based on his $25,000 annual income.
"I'm healthy, so it's not in the budget," Mr. Meiffren said after the lunch rush. He lost a full-time job—and his insurance—last fall. He said he moved to Portland from Los Angeles in March, looking for "a better vibe" and a lower cost of living.
Nationwide, there are 11.6 million people ages 18 to 34 who are uninsured, according to the Department of Health and Human Services. The federal government's challenge this fall will be getting them to buy health-care coverage, which many consider a luxury they can do without. Hospitals already must treat all emergencies, and uninsured patients are responsible for the bills.
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