The main point: One important population that would be especially impacted by potential cuts to Medicaid in Congress’s reconciliation bill would be young adults.

The numbers: Roughly 3 in 10 young adults 18-24 are insured through Medicaid. The Medicaid cuts in the reconciliation bill would lead many of them to lose coverage.

Here’s why:

Medicaid Expansion: Many young adults are eligible for Medicaid through the Medicaid expansion under the Affordable Care Act. Several of the proposed changes, including requiring some beneficiaries to pay for care, are targeted only at beneficiaries covered through expansion, meaning young adults could be disproportionately impacted. The bill also proposes removing incentives for more states to expand Medicaid, which would eliminate a key opportunity to increase insurance coverage for young adults.
Paperwork: Several of the proposed changes increase application and other paperwork requirements (e.g., work-reporting requirements, more frequent eligibility checks for the expansion population, making it harder to enroll and maintain coverage). Research shows that young adults struggle more than older adults to successfully navigate bureaucracy because they lack experience, face challenges engaging agency staff, and have difficulty gathering required documentation and completing paperwork.
Transience: Address-verification requirements would be difficult for young adults to navigate, as they are more likely to move than older adults.
Employment: Young adults are more likely than other adults to work low-wage jobs, work in the gig economy, or be unemployed, and therefore covered by Medicaid.

Why it’s important: While young adults are generally healthier than the overall adult population, they have particular needs that make accessing care vital and that are particularly targeted by many of the proposed cuts — behavioral health, reproductive health, prevention, etc.

Research has shown that Medicaid coverage supports access to health services, helps stabilize beneficiaries’ finances, and can reduce mortality among younger adults.
The risk of substance use and addiction is particularly high in young adulthood, when the brain is still developing. Being able to access substance use prevention and treatment services is critical for this population.