This is basically a working group actively saving for retirement. We wanted to see whether they had health coverage, where they got coverage, and what their out-of-pocket costs were like and what that meant for access to care.

Few people in these plans would recommend them to friends or co-workers. By focusing exclusively on the demand side, incentives give disproportionate responsibility on cost control to people with health problems or lower incomes.

In the absence of doing broader system reform and more universal coverage, this policy at least addresses the most tenuous time in terms of health care?entrance into the labor market, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help.

That raises some concerns about the decisions people are making when faced with high out-of-pocket expenses.

Young adults probably have the weakest connection to employer-based coverage. They're more likely to get jobs that are low wage, part time or with small businesses that can't offer insurance.

Among adults who have the consumer-driven health plans, we are finding lower satisfaction with quality of care, out-of-pocket costs, and a low satisfaction in their plans overall.

What's surprising is the instability of coverage across low and moderate incomes. There is a sense of some risk and some high cost burdens among both low- and moderate-income working households in this age group.

Allowing Medicare buy-in for caregivers of Medicare beneficiaries, or tax credits for caregivers' medical expenses, could ease their financial burden.

Obviously, this is an age where chronic conditions start popping up. This raises concerns about people's ability to maintain their health as they move toward retirement and toward Medicare.