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Frank Gray

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Will health insurance exchanges draw many takers?

I recall when I got one of my first full-time jobs being told by some manager a lot older than I was that the company offered comprehensive medical coverage. The company seemed proud to provide that benefit.

Being in my early 20s, though, I wasn’t particularly excited to hear it. I was just happy to have a job and wanted things like a football called the Duke, a new clutch in my MG and a TV.

That’s because when you’re a guy in your 20s you don’t worry about dying or developing serious health problems. Those were things that always happened to someone else.

Eventually, by the time they’re in their 30s and 40s, most people start thinking differently. They buy houses and cars and have kids, and insurance represents protection for those assets.

Today, what are called health insurance exchanges are supposed to open all over, letting people who don’t have health insurance shop for it, and in some cases they will be eligible for subsidized insurance, which means they won’t have to pay much.

I wonder what kind of rush there will be, whether the throngs of people who don’t have insurance will be clamoring to sign up, or whether there will a ho-hum reaction by a lot of people.

I long ago came to the conclusion that insurance, to some people, is either something they don’t need or nothing but a headache.

Consider car insurance. If you want to drive a car in Indiana, you have to have two things: a license and insurance.

A person can buy the minimum required auto insurance at a reasonable rate and make monthly payments.

If you get caught driving without car insurance, you can be fined and lose your license, which is a good incentive to buy insurance. People have to be able to drive.

But an estimated 14 percent of all drivers in Indiana don’t bother to buy any auto insurance at all. That’s one in seven drivers, and in some states an estimated one in four drivers don’t buy insurance.

Then there’s the issue of people who don’t bother to get driver’s licenses. If you’re careful, wear a seat belt, don’t speed or run stop signs, you can drive for years without a license and never get caught, so it’s hard to say how many people are driving without licenses.

The fact that people won’t buy car insurance makes me wonder how many people who don’t have health insurance will bother to sign up at the exchanges in the next couple of months.

Certainly, for some people, the exchanges will be welcome. People who have had pre-existing conditions, who have been turned down by insurers, especially older workers, will probably be delighted. Parents who are carrying their grown children on their own insurance might send their kids to the exchange to provide for themselves because the price for family coverage is expensive.

I’m skeptical, though, that a lot of uninsured 20-somethings are going to be excited by the new program, even when threatened with what will be a small penalty come tax time.

So I’m just going to watch what happens.

I’m sure a lot of people who are accustomed to being uninsured will opt for the cheapest option when forced to participate, and we’ll eventually hear lots of horror stories of people who bought insurance and then found out all kinds of things weren’t covered.

But that’s what happens when you try to get everyone to pay their own way.

Frank Gray reflects on his and others’ experiences in columns published Sunday, Tuesday and Thursday. He can be reached by phone at 461-8376, by fax at 461-8893, or by email at You can also follow him on Twitter @FrankGrayJG.