When Tamisha Jackson turned 22 and graduated from college last year, she was pushed off her parents' health insurance plan.
Since then, she's become a graduate student in women's studies at Towson University but hasn't been able to foot the $1,400 annual bill for coverage from the school. To compensate, she's been popping vitamins and watching her step.
"I just didn't want to have to pay such a large sum," said Jackson, who lives with her parents in Prince George's County and works as a graduate assistant in the school's Center for Student Diversity. "I've been fortunate not to have serious issues."
Jackson is a member of the largest group of uninsured Americans: young adults. Close to a third of those between 18 and 24 years old lack coverage. But when a provision of national health care reform kicks in Thursday, she and thousands of others like her in Maryland — and millions nationwide — will have the option to return to their parents' insurance plans.
Other provisions will also become effective Thursday that, among other things, ban lifetime benefit caps, require no-cost preventive medical services such as mammograms, and begin to close the so-called "doughnut hole" for seniors on federal prescription drug plans. The more costly and complex insurance exchanges, which will allow the uninsured to shop for coverage and subsidies, won't go into effect until 2014.
The young adult provision is among the less controversial provisions and isn't expected to have much of an impact on premiums in general. Supporters say it also could help fill the health care system with healthy people, supporting a pool that will eventually take on more sickly patients.
The conservative Heritage Foundation, however, notes that several insurers have attributed a portion of this year's rate hikes to all the new provisions.
Many Americans also remain opposed to the law in general because of the cost to expand government programs. Republicans in Congress have made it an election-year issue, leading some Democrats to distance themselves from the reform package. The Republicans say they will try and repeal the law or block funding for some measures.
And just because insurance is available doesn't mean everyone will take advantage of it. Jackson will return to her parents' health insurance plan as soon as possible, but she said that many of her friends who have gone without insurance for long periods are likely to remain uninsured for now. Either their parents won't add them to their policies, or they don't believe they need coverage.
Supporters believe the new provisions will put a dent in the number of uninsured, some 741,000 in Maryland and 50.7 million nationally, according to new U.S. census figures. The government estimates that up to 2 million young adults nationally and 18,000 in Maryland will enroll in their parents' plans in 2011.
President Barack Obama visited Wednesday with Americans who are benefiting from the new health care law as he marked the passage six months ago of the landmark legislation.
"When I came into office, obviously we were confronted with an historic crisis," Obama told a small gathering in the backyard of a Virginia man who suffers from hemophilia and hit a lifetime limit in his health coverage. Obama also met Wednesday with state insurance commissioners whom the administration is counting on to protect consumers from excessive rate hikes by insurance companies.
As for the young adults provision, many health insurers, including Aetna, Humana, WellPoint, CareFirst BlueCross BlueShield and United Healthcare, extended policies immediately after overall health care law passed in March, so there would be no disruptions for those graduating from college. Jackson, and those whose parents are on other plans, will be able to return to coverage during the next enrollment period.
Some young adults already have been afforded coverage in Maryland, one of several states that have enacted protections in recent years.
The state requires large employers with private health insurance plans to allow unmarried dependents to remain on their parents' policies until they are 25. The federal law is even broader; it will require another year of coverage, will include married children and will apply to self-insured employers and the federal government, which employs Jackson's parents.
Vincent DeMarco, president of the advocacy group Maryland Citizens' Health Initiative, plans to highlight the changes at rallies in Towson and College Park Thursday. He said the provision will reduce the number of uninsured in the state, even though Maryland has a law on the books.
"There are important new categories of people who will qualify," DeMarco said. "This will be good for everyone."
DeMarco said that the young uninsured will use the emergency room less, bringing down the amount of uncompensated care now provided by hospitals. And he said young healthy adults are crucial for the system's long-term sustainability.