Written by HealthHarbor

If you are one of the 20-something set, your ears should have been burning during the recent health care reform debate. Young adults were a pivotal piece of the dialogue, and in many respects the legislation was built around them. While they may not have the lobbying clout of the insurance industry or the voting pull of Medicare recipients, young adults held the key to the math behind the reform: Including them in the risk pool was essential for making any kind of revamped health care financing system work.

Young adults have traditionally had spotty coverage when it comes to their health insurance. According to the National Conference of State Legislatures , 28% of America’s uninsured are between the ages of 20 and 29, while that group represents less than 15% of the population. While some 20-somethings get stripped down plans, others go with no coverage at all. It is a combination of their financial situation – often studying or trying entry-level jobs without great benefits – as well as the fact that they are generally healthy and not heavy users of health care services, compared to their middle-aged or elderly counterparts, that makes their uninsured ratio so much higher than the national average.

The problem is that without the 20-something crew being part of the broader insurance pool, the math of spreading the risk pool around doesn’t work. If the only people who are in the insurance pool are already sick or heavy users of healthcare services (e.g. young families), then it is a little like car insurance where only the accident-prone are buying the product.

In order to sweeten the deal for young adults to be insured, Congress used several carrots and a couple sticks. Here is a summary of how health reform may impact you if you are a young adult, 20 to 30 years old.

You can remain on your parents’ insurance until you are 26 years old.

If you are a student, unemployed, or someone trying to get their foot in the door of the workplace, you can remain on your parents insurance until age 26 as long as you are considered a dependent of theirs. You also cannot have insurance offered to you from your employer. It isn’t free – premiums will have to be paid per the policy guidelines, but it should allow more young adults to remain covered while they are finding their place in the workforce. While some states already have laws which require coverage similar to the new law, others such as Wyoming and Virginia require children to drop from parents’ coverage as early as age 19.

You may be eligible for health coverage subsidies.

If you are in the private market for your health insurance, the odds are that you will qualify for subsidized health premiums. Statistically, 20-somethings are not yet rolling in the dough. Most typically earn incomes that are less than the 400% of Federal Poverty Level required to be eligible for premium assistance. This should make health coverage more affordable for those who may have in the past felt the cost of insurance wasn’t a good value given their healthy status. When the final law has settled in later this decade, no American will pay more than 8% of his or her income for health coverage. Given the average salary of a 20-something, this will likely be a favorable regulation for many of them.

By 2014, you will have to carry insurance.

This may be insurance you obtain through your employer, through your parents plan, by way of a new Health Insurance Exchange, or from Medicaid if you are lower income. Regardless, you need to find insurance at some point, even if you are perfectly healthy, or pay a fine of $750 (or 2% of your income, whichever is greater) starting in 2014.

If fortunes allow, get ready to pay more in taxes if you become a higher wage earner.

Health reform created some permanent changes, and permanent costs. The good news is that as a younger person in the workforce, you likely have an income at a level that will not bear most of the new taxes associated with reform. As you grow into your career, especially if you are lucky enough to earn more than $200,000 a year or be the recipient of a "Cadillac" tax plan, you will be one of the Americans paying for health reform. Since the cost of health reform is recurring, you have your entire career to contribute to the costs. Given that it will mainly affect those with higher incomes, we sincerely hope you fall into that category someday! All kidding aside, the generation entering the workforce today will need to cover much of the health reform cost during their lifetimes, so it is important to be astute with your taxes and proactive with your government if you have ideas on how to best foot the bill.

Consider a career in Family Practice.

Health reform will gradually shift the demand for medical care away from specialists like Radiologist and Cardiologists to generalist like Family Practice Physicians, Nurse Practicioners, Internists, and Physician Assistants. These primary care clinicians will be asked to take care of more of our sick, and will be rewarded for it. If you have an aptitude for it and a willingness to commit to the school it requires, choosing a lifelong career in primary care couldn’t be more timely.

Health reform affects everyone, but it creates relief as well as opportunity for 20-somethings on a scale that none of the other generations can claim. In many cases, this is their health reform. Reform put in to place so that today’s young adults can fully participate in and refine this new health system over the course of their working lives. The more you know about reform as it is rolled out, the better positioned you’ll be to take advantage of the help it may provide or the doors it may open.