Lucas Wyant doesn’t worry much about worst-case scenarios, and that’s why he hasn’t gotten around to buying health insurance — despite the state mandate. He’s a friendly, relaxed 20-something guy from Indiana, who’s never gotten seriously ill or injured. He works as a house painter for a small company that doesn’t provide insurance. He lives modestly in a Northampton walk-up apartment. When the painting work is coming in, he makes just too much money to qualify for Commonwealth Care, but he doesn’t see the point in buying private health insurance — despite pleas from his girlfriend and his parents.Health reformers know Lucas’ type well. The Division of Health and Finance — in a December survey — actually found that healthy males in their twenties were making up the lion share of mandate-snubbers. And it’s a problem for the system, because insurance companies say without the healthy subscribers in the mix, the overall cost of insuring everyone will just go up.

But that’s not Lucas’ problem. He’s got to worry about paying his bills. He says the one factor that IS likely to force his hand is the state’s tax penalty. The first year, when the penalty was only $219, he never saw a bill — somehow, he managed to get under the radar. So that’s why he decided not to worry about this year’s penalty, which could be up to $900. Maybe they’ll forget about him again, he’s hoping. But if they don’t and he DOES find himself with a $900 bill, he’ll probably break down and try to find some health insurance. (Next year the penalty is even higher.) He also admits to getting a bit of reality check when his father, who is insured, recently had a bad car accident and needed a lot of expensive care.

In fact, Lucas has a few options for health insurance — and is only now starting to look into them. His painting company recently laid him off while the work is slow, so he’s collecting unemployment — and has applied for health insurance though the Medical Security Plan. If that doesn’t work, or after that runs out, he’s going to see if he can qualify for Commonwealth Care. But if he starts working again, he’s pretty sure that will tip his salary out of the pool.

He says some of his fellow painters already tried to get Commonwealth Care while they WERE working, but there was a glitch. The owner of the company thought his employees were eligible to sign up for his health insurance, but in fact, they weren’t……still, the Connector Board believed they had an employer-option and turned them down for Comm Care. Lucas says that level of hassle was enough to stop most of them from advocating further.

It’s worth noting that Commonwealth Choice (which brokers the private, non-subsidized plans) has a cheaper option for young, healthy people like Lucas. That very fact has been controversial, because older folks think it’s unfair. But reform supporters say that may be the only way to get them into the pool. Lucas, however, hadn’t heard about this plan.