Of all of the claims and counterclaims spouted during yesterday's floor debate in the House of Representatives, I was most stunned by Rep. Joe Barton's assertion that 10-15 million uninsured young adults don't want health insurance:

"Congressman [George] Miller talked about the 40 to 50 million Americans who are uninsured, and he’s right. But of those 40 to 50 million, 15 to 20 million are in this country illegally. Ten to 15 million are young Americans who don’t want insurance. When you really boil it down, there are five to 10 million Americans that have a pre-existing condition or work where the insurance is not provided and they can’t afford it. Our plan covers them."

I immediately thought of the dozens of young people I've encountered at work, in my family and in my community over the last several years who are stressed out because they don't have health coverage. Some of them have chronic conditions that are going unattended. Some find themselves with acute health problems that they hope will go away because they can't pay a doctor. Others don't have a particular health problem, but live in fear of getting sick or having an accident. I remembered my own time in grad school, when I could not longer make my COBRA payments, and I prayed every day that nothing would happen before I got a job with benefits. It was the early 1980s and I was able-bodied then.

In fact, scholars say that historically, younger people tend to favor public spending on social goods such as health care. So when I heard Rep. Barton's declaration, I couldn't help but wonder, "Where are these young people who don't want health insurance?"

It turns out there's a term for this group of uninsured Americans - the "young invincibles," and partisans on each side of the health care debate have been battling for their support. Like the young people I've known, they have some pretty harrowing tales to tell:

Brandon is part of an organization, Young Invincibles, lobbying in favor of the Democrats' health care reform proposals:

"Young Invincibles is a new group of 18 to 34 year-olds across the country who are committed to making sure young people are heard in the debate about the future of our country. Our campaign will tell the truth about how the current system fails young people, dispel the myth that we don’t care about health care, and add our voices to the millions of Americans demanding change. You will be hearing a lot from us in the weeks and months to come."

A February, 2009 New York Times story details the lengths that some uninsured young adults are going to in order to get their health care needs met:

They borrow leftover prescription drugs from friends, attempt to self-diagnose ailments online, stretch their diabetes and asthma medicines for as long as possible and set their own broken bones. When emergencies strike, they rarely can afford the bills that follow.

When those emergencies do strike, these young adults end up in the emergency room -- getting the most expensive care, often for conditions that could have been treated more easily and cheaply with regular medical care. When they can't pay their hospital bills, the weight falls on the rest of us, through already over-burdened state charitable care funds that are financed by our taxes and insurance premiums. In my home state, New Jersey, charitable care funding hasn't kept pace with rising hospital costs, as this April, 2009 article about Gov. Corzine's most recent budget from NJBiz makes clear:

"The good news for [New Jersey Hospital Association] is the state is not slashing charity care funding by 15.5 percent, as it did last budget season. The bad news is the $605 million in proposed funding will still reimburse hospitals for less than half the roughly $1.3 billion in annual charity care they provide to uninsured patients."

Despite those grim realities, not all young voters support health care reform. Young Americans For Freedom, an organization of conservative campus activists, issued this action alert last Wednesday:

Young Americans for Freedom (YAF) Chairman Erik Johnson urges all Americans to take a stand against Nancy Pelosi’s liberal dogma of government controlled universal health care.  Universal health care will cost Americans greatly, in terms of their physical and financial health.

Apart from their ideological opposition, [erhaps part of what has the YAF activists in a twirl is a recent study by Anthem Blue Cross Blue Shield finding that under the proposed health care reforms, healthy young workers will pay higher premiums to offset the cost of supporting older, sicker citizens. A Colorado Springs Business Journal news story on the report said that researchers found the universal coverage mandate could force premiums up by 140 percent. Researchers quoted in the story argued over the validity of the assumptions underlying the study's calculations. For one thing, it didn't factor in projected savings from the planned health care exchanges and other reforms. But Ralph Pollock, Executive Director of the Business Health Forum, drew a different lesson for reporter Amy Gillentine:

“As we work through the reform process it is evident that money needs to be taken out of the system — period. That’s going to take sacrifice on all parts: insurers, health providers and consumers. Individuals and employers must stop accepting health care and coverage prices at face value, and demand health providers and insurers bring down costs in the system. As consumers, we should take a hard look at what we demand out of our health care system and use it wisely.”

That may mean that young adults will have to become more engaged than ever in the policy debates over health care, especially in the next crucial few weeks as the final bill takes form.