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Two weeks ago, at the University of Maryland, President Barack Obama directly enlisted young people in the fight for health care reform, telling the crowd, “We need the voices of young people to transform this nation.— His speech immediately shifted the debate from “Do young people care about health care reform?— (yes, we care) to “What should young people be fighting for?—[IMGCAP(1)]At the end of the legislative process, health care reform must be a good deal for 19 to 29 year olds, the most uninsured age group in the country.Here’s our list of the top seven things that young people want from reform. Each works only if the others are part of the package.1. Universal Coverage. Young people want health insurance. There are a number of reasons that they currently don’t have it. High rates of unemployment force young people into the expensive private insurance market. Even those with jobs often don’t have coverage. Some are denied coverage because of pre-existing conditions or because they have recently moved. Regardless of the reason, young people recognize the need for health insurance and support universal coverage.2. Affordability. Getting to universality through an individual mandate has the potential to add financial burdens on those with low wages, student loan debt and little savings. Two reform proposals are critical here. First, young people need financial assistance to make coverage affordable.The various plans working through Congress include subsidies to help cover the cost of premiums. Some are more generous than others. Second, youngAmericans need a competitive insurance exchange — including a public option — that provides quality coverage options and keeps the cost of individual plans down if their employer doesn’t cover them.3. Cost Containment. After young Americans have insurance, we need to make sure that it doesn’t break the bank. More than one-third of young adults report problems paying medical bills, and one-fourth of young adults have medical debt. And that includes people with insurance! When you look only at the uninsured, nearly half of them report problems with medical bills and almost 40 percent have medical debt. Reform that caps the amount of money that insurance companies can charge for co-pays, out-of-pocket expenses and deductibles will provide real value.4. Ending Discrimination and Other Abuses. Insurance reform must end discrimination for pre-existing conditions (one in six young adults have a common chronic condition) and gender discrimination. Reform must also stop insurance companies from dropping those who get sick.5. Better Employer-Based Coverage. Young people lucky enough to have a job need to be better served by the employer-based system. Currently, 28 percent of young adults who are employed are uninsured (compared with 16 percent of working older Americans). And among young people working for small businesses, the uninsured rate is 50 percent. Reform must mandate that employers insure their employees and provide tax credits to small businesses so they can afford it.6. Insurance Security. Young people need insurance security as they enter the workforce, change jobs, move, start businesses or go back to school.Gaps in coverage mean prescriptions that don’t get filled, doctor visits that don’t happen and tests that go undone. Two-thirds of young people who had a gap in coverage went without needed care because of costs. Reform must allow young adults to stay on their parents’ insurance until age 26.For those that do not remain dependants and aren’t covered through work, the exchange must be there.7. Preventative Care. Reform must offer free preventative care to all insured people and invest in the public health system. There has been lots of talk about “young adult— plans and catastrophic coverage. These policies, which are designed to stave off financial ruin in the event of a major accident or illness, often have high deductibles and provide only bare-bones benefits. These plans must be subject to the full range of insurance reforms, including covering preventative care.The status quo simply does not work for young people. The system is broken. And young people — 22 million of whom voted in the last election (more than those who are older than 65) — are counting on politicians and policymakers to deliver on the promise of reform.Heather Smith is president of Rock the Vote.

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