The ââ are what health policy wonks call healthy young adults (18-30) who donât see being uninsured as a problem. But it is a problem, at least for the success of the Affordable Care Act.
Thatâs why the Department of Health and Human Services is spending $30,000 on prizes for a national video contest, in a frank appeal to the YouTube generation.
The digital demographic may not know co-pays from co-insurance, but creating and uploading free âcontentâ practically defines that generation. HHS hopes to tap that creativity and essentially get young adults to market Obamacare to themselves.
HHS Secretary Kathleen Sebelius announced during a visit to , a federally qualified health clinic in Houston.
âW±đâr±đ encouraging folks to create a song, or a graphic, or a video about the lawâs benefits,â Sebelius said. âLike staying on their parentâs plan until theyâre 26, not being denied coverage because of a pre-existing health condition.â
If those topics donât sound super sexy, Sebelius nevertheless seemed confident that the young folks would figure out creative ways to sell it. The contest will also allow people to vote online for their favorites in various categories, and then a grand prize winner will be selected after âa final round of voting and judgingâ -â presumably by HHS, although the website doesnât specify.
If the prize amounts donât seem Hollywood-level (the most anyone can win is $6,500), HHS also noted that the first 100 entrants get a âStay Healthyâ kit, which âincludes a t-shirt, first aid kit, sun protection kit and water bottle.â
In Houston, Sebelius made the announcement before community health workers who had gathered for a training session on how to explain Obamacare to people under 34. The training session was run by , an advocacy group that represents the interests of young people in the fight for health reform.
Sebelius acknowledged that when twentysomethings wake up in the morning, âhealth insurance is not the first thing on their minds.â But, she says, friends, family members, health care providers and trained organizers can educate young adults about the dangers of an accident or sudden diagnosis.
She talked about her own two sons. The older son is a lawyer and has insurance; the younger one, John, is 29 and a self-employed âentrepreneurial artist.â John attended the Rhode Island School of Design and at one point made the news for .
âHe now has a masterâs in fine arts,â Sebelius says. âHeâs trying to knit together a way to pay his bills while he pursues his art. So, Iâve seen sort of up close and personal how complicated that can be and how difficult that is.â
Although John does have an insurance policy, Sebelius said âitâs always a worry, itâs always a problem. He isnât in a plan that heâs sure of from moment to moment or day to day. So I know how complicated this can be.â
Texas Governor Rick Perry released a short  dismissing the video contest as a gimmick. âIf Obamacare were sound health care policy, Secretary Sebelius wouldnât have to resort to video contests and prizes to tempt people to sign up. Texans are already subject to too much costly and burdensome federal regulation, and Obamacare only makes the problem worse.â
Sebelius also spent part of her visit meeting privately with a select group of Houston politicians and health care stakeholders. She said local leaders in major Texas cities understand what the state leaders do not, that Obamacare will bring relief to overburdened local hospitals and property taxpayers, who foot the bill for the uninsured.
, a Republican and the county executive for Harris County where Houston is located, stood by Sebelius during a press conference. They were joined by Houstonâs mayor, Annise Parker, a Democrat.
âThe law is in place,â Emmett said. âPeople are still arguing about whether it should be repealed or shouldnât be repealed, but it is in place. And in the meantime, here in Harris County we have an inordinate number of underinsured and uninsured people -â who right now the taxpayers of Harris County are paying for [their] health care.â
Emmett said Texas made a mistake in rejecting the health lawâs provisions to  to allow childless adults and those earning below 133 percent of the federal poverty level to sign up. The federal government would pick up the tab for the newly eligible for the first 3 years, and gradually decrease to 90 percent by 2020.
âPersonally I think leaving that money on the table, those are our taxpayer dollars that are already in Washington. And if we donât reimburse through Medicaid then the local taxpayer has to pick up that tab. So, yes, I think it was a mistake. Costs us twice.â
Sebelius said itâs  for Texas to decide to expand Medicaid to cover low-income adults.
âW±đâr±đ open to a program that looks uniquely Texan,â she said. But the impetus will have to come from hospital leaders, business leaders, and faith leaders fashioning a solution with state legislators. âW±đâr±đ eager to have those conversations but I think they need to start with a Texas group coming together and talking to us,â she said. âThis is really not a Washington-to-Texas conversation.â
This story is part of a collaboration that includes , and Kaiser Health News.