Published: November 18, 2013
Bobby Schofield is 25 years old and healthy - but a vexing problem for officials running the state's new health insurance marketplace.
He last had coverage at the age of 11, under his father's policy.
Fourteen years later, he's part of the "young invincibles" - a demographic highly sought by Connect for Health Colorado, but also highly uncertain to buy health insurance policies.
Exchange officials are banking on those people to enroll en masse, especially as the Dec. 15 deadline looms for coverage beginning Jan. 1.
The stakes are high: The number of healthy enrollees could mean the difference between manageable insurance costs or skyrocketing premiums in 2015 and beyond, experts say.
"I sort of think of them as the linchpin of success," said Michele Lueck, Colorado Health Institute's president and chief executive. "... They need to be enrolled, so that we can balance the risk of all the lives that are covered."
It's a group that isn't always willing to pay for coverage.
Insurers bank on healthier policyholders - often people younger than 35 - to offset the cost of sicker patients.
But young people are generally reluctant to purchase health insurance, often citing cost, Lueck said.
Twenty-seven percent of Coloradans ages 19 to 26 are uninsured, according to the 2013 Colorado Health Access Survey - the state's largest uninsured age group. Nearly 23 percent of Coloradans ages 27 to 34 also went uninsured.
Newly unemployed, Schofield might end up being eligible for expanded Medicaid benefits if he doesn't soon find a job. But if he makes more than about $15,000 next year, he'll be mandated to purchase coverage because of the Affordable Care Act, or Obamacare.
In that case, he'd rather pay a fine than commit money to a monthly health insurance premium.
"What do you need it for?" Schofield said. "I get sick, I take care of myself. If I break my arm, it's like either way I'm paying out of my pocket. To me, I've never had it - why should I have to have it?"
No demographics have been released for the 3,408 people covered on plans purchased in October through Connect for Health Colorado, though officials will soon release those statistics, said Linda Kanamine, a marketplace spokeswoman.
Early results from a few other states, though, have signaled a worrisome trend.
Most Californians who applied were older people with health problems.
In Kentucky, nearly 3 of 4 enrollees were older than 35. About 23 percent of enrollees in Washington state were between 18 and 34.
Marketplace officials and other, unaffiliated nonprofits have stepped up efforts in recent weeks to reach that critical group.
On Oct. 1, Connect for Health Colorado embarked on a three-month, $4.2 million marketing campaign to attract enrollees - often tailoring the message to young, uninsured Coloradans.
"If you push yourself, protect yourself," one ad proclaims, after listing the hospital bills for various skateboarding accidents. It's been displayed on billboards, Hulu and the Internet music streaming site Pandora.
Two Colorado nonprofits recently needed just $5,000 to garner national attention for their ads asking "Got Insurance?"
One ad featured three young men performing a keg stand, asking if they have "brosurance."
Another, depicting a man standing next to a woman holding birth control, read: "My health insurance covers the pill, which means all I have to worry about is getting him between the covers."
ProgressNow Colorado and the Colorado Consumer Health Initiative produced the ads, posting them online and watching them go viral over social media.
"What we heard when we were talking to young adults here in Colorado is we have to kind of go to where they are," said Adam Fox, Colorado Consumer Health Initiative's director of strategic engagement.
Many people criticized the ads for their portrayal of women, labeling them demeaning. Fox said the ads are working: The campaign's website received 10 million hits Tuesday and Wednesday.
"If it gets people talking about health insurance and the importance of health insurance, that's what we're really trying to get across," Fox said. "And I think we're succeeding in that."
The Associated Press contributed to this report