The Senate’s effort to replace the Affordable Care Act — which greatlyincreased the number of young people covered by health insurance —could drive many of them back off again. And many of those whoremain will be paying more for less coverage, or will be priced outof the market altogether.

The good news: The Senate Republicans’ version of an earlierHouse bill does keep a popular provision of the ACA allowing youngadults up to age 26 to stay on their parents’ insurance and someyoung adults will enjoy lower premiums in the private insurancemarketplaces.

The bad news, according to a report from Kaiser Health News, is the billwould also “dramatically reduce health coverage and care for other youngadults, according to the bill’s many critics, which include theAmerican Medical Association and the American HospitalAssociation.”

If states opt out of requiring insurers to provide benefits suchas maternity care, mental health care, and prescription drugs —features which get regular use by young adults — millennials won’tbe getting the care they need. In addition, while they might findthe premiums more attractive and thus buy coverage they mightotherwise not have, when they come to use their policies, theycould find gaps in coverage just where they need it.

One of those areas could be mental health care. An NBC report points out mental health problems are onthe rise among college students. Citing data from the NationalAlliance on Mental Illness, more than 75 percent of all mentalhealth conditions begin before the age of 24 — making millennials,particularly those in college, most at risk.

The report also cites the Center for Collegiate Mental Health atPenn State University which says, based on data it gathers from 139 institutions, thenumber of students seeking help soared 50 percent between 2015 and2016. Mental health care is not high on the priority list in theSenate bill.

Young adults, says KHN, could also be subject to other costincreases: larger deductibles, less help with out-of-pocketexpenses, and for some, no subsidies to help pay for premiums,because the bill would reduce the income threshold foreligibility.

KHN reports approximately 27 percent of the 12.2 millionconsumers who signed up for health insurance through exchanges in2017 were 18 to 34 years old. Covered California, the state’sexchange, put the number of its enrollees in that age group at 37percent for this year.

It also cites Walter Zelman, chairman of the public healthdepartment at Cal State-Los Angeles, who says those who will facethe most damage in the Senate bill are millennials covered byMedicaid. Not only does the Senate bill stop the expansion ofMedicaid which was responsible for so many people signing up, butit cuts available funding for the program.