AUSTIN, Texas -- When it's a decision between buying groceries or health insurance each month, the choice is clear.
Jennifer Tapia, 24, prefers to eat.
Tapia, who works part time at H.E.B. grocery store, says her job does not provide health insurance, and individual coverage for her could cost as much as $200 a month -- more than she can afford. It's a common story for young adults. According to the U.S. Census Bureau, one in three adults between 18 and 24 went without health insurance during 1995, more than double the rate of other age groups. Between 1992 and 1994, more than half of all 18-to-24-year-olds went without health insurance for at least one month. Young adults often are left out of the debate about health insurance reform because they tend to be healthy and need less care. But young adults are not immune to car accidents or other mishaps, and for the uninsured, injuries, even minor ones, can bring severe financial consequences. For Tapia, going without health insurance seemed a reasonable risk -- until she got hurt. A relatively minor injury cost her $1,000. Two years ago, before moving to Austin from San Antonio, she put her hand through a glass window, a "dumb mistake" she says that led to a trip to the emergency room and 43 stitches. The ambulance ride alone was $200. "The costs are just unreal," she said. "And you have no idea it's going to be so much until you get that first bill. Just for drawing blood, it's $44." Going without insurance cost Jesse Saldivar, 23, more than $800. Saldivar is a nurse's aide at a nursing home that does not offer health insurance. Lifting patients from their beds at a previous job has given him a recurring back injury and a backlog of medical bills. At more than $100 per visit, treatment has become too expensive, and he has stopped seeing doctors or chiropractors, although his pain persists. He and his wife, Michelle Johnston, 18, are paying off his medical bills little by little each month. Johnston works part-time at Randalls and plans to start attending classes at Austin Community College. She doesn't have access to health insurance, either, and said she worries about getting sick or having an accident. "Already we've got bills to pay," she said. "What would we do if something else happened? How would we ever pay for it?" Arlene Spurlock, 24, who lives in Leander with her husband, has not had health insurance since she was 18 and covered under her parents' plan. Since then, she's worked jobs at temp agencies and various retail stores that did not provide health insurance. Spurlock has recently finished paying off a $2,000 hospital bill she incurred a year and a half ago when she was rushed to the emergency room for alcohol poisoning. While she spent just six hours in the hospital, the bills followed her for more than a year. "There were doctors' bills, hospital bills, urinalysis bills, they just never stopped," Spurlock said. "I had to call the billing departments and tell them I couldn't pay at once, that I could only pay what I could afford, which wasn't much. I'd pay off one bill one month, and another the next. It took about 10 months before I paid them all." Spurlock said she looked into getting a private health insurance policy, but gave up her search when she found out full-coverage, including dental visits, could cost her up to $500 a month, more than her rent. Spurlock is currently unemployed, but does not qualify for Medicaid insurance, which is available to some low-income families, because her husband works full time and she has a savings account worth $1,000. She can't get insurance through her husband's job either. Coverage options are limited for young adults who don't have access to health insurance through an employer. Full-time students often are covered under their parents' plan or through school. The University of Texas, for example, offers student health insurance starting at $174 for the spring semester. …