Poor and bludgeoned by debt accrued over four years of college – but otherwise healthy – medical insurance just isn't in the cards for aspiring-artist Joanna Zobjeck.

The 23-year-old sat on the concrete steps leading up to Reeve Memorial Union during a sunny, autumn afternoon at the University of Wisconsin-Oshkosh as she asked, "What am I going to do? Stop eating?"

It's a frustrated retort aimed at proposed health care legislation that would mandate everyone buy insurance.

A bill passed by the House last weekend bars insurance companies from denying coverage on the basis of pre-existing medical conditions or charging higher premiums on the basis of gender or medical history. Young adults are the balance to the new rule, which also forces those least likely to need medical care to participate in a health plan in order to keep prices from inflating.

"There's no way I could afford it right now," Zobjeck said. She works only part-time as an information technology intern on campus while gearing up for graduation in May.

Her plight is mirrored by many twenty-somethings who no longer depend on their parents yet haven't reached their own financial stability. Many attend college or work jobs, such as bartending or waiting tables, which usually offer no benefits.

Young adults age 20 to 24 are the most likely to be uninsured, according to the Centers for Disease Control. One out of every three does not have health insurance. Of those between 18 and 29, about 30 percent don't have it.

Despite these statistics, the health care debate has focused almost entirely on coverage for the sick and elderly.

"When they talk about health care reform, they're thinking about coverage for the elderly. I really do feel like the college bunch is being looked over. We're a bogus grey area," Zobjeck said.

But her demographic has been talked about, only for different reasons.

The insurance industry says requiring healthy young adults to participate in a plan is crucial to any reform package that covers individuals with pre-existing medical conditions. Otherwise, industry leaders fear, people would wait to buy coverage until a medical need arises.

"It would be like buying homeowners insurance when your house is already on fire," said Sheila Jenkins, president of Menasha-based Network Health Plan. "Most of us rational thinkers wouldn't choose to buy insurance unless we know there's going to be an expense."

"At the end of the day, people really should have affordable access to health insurance, but the only way to make it affordable is for all of us to participate," she said.

The idea puts many young adults on edge.

"People can't just get (health insurance) handed to them. They should take some action towards being healthy," said health promotions student Michelle Zach, 24, who will soon lose the coverage she receives through her parents.

She said she's worried about finding affordable insurance this spring and fears the possibility of paying higher premiums to offset others' unhealthy lifestyles.

"It's hard to decide (whether to support reform proposals) because you want it to be equal, but then you ask why am I paying for someone who continues to smoke a carton a day," said Shannon Ward, 25, who tutors part time at UWO and is uninsured.

A key question in the debate remains how to allocate premiums, Jenkins said.

"There's a lot of concern about whether the cost should be spread equally to everybody or whether it should be modified based on your age and health status," she said. "Many proposals now don't allow for significant variation based on age."

The House bill and a proposed Senate bill each offer some form of government subsidy to help low-income individuals and families buy insurance. But trying to understand the massive bills can be cumbersome and confusing.

"I feel kind of left in the dark," Ward said when asked if she believes any of the reform bills would help her situation. "All we have are politicians to listen to who are unreliable."

The health care debate has proven divisive and, except for a few centrist lawmakers, partisan.

The Democrat-controlled House passed its $1.2 trillion bill by 220-215 votes. Republican opposition was nearly unanimous.

The Senate is even more divided. Majority Leader Harry Reid, D-Nev., has yet to schedule floor debate and hinted last week that senators may not be able to finish health care this year.

Both the House and Senate bills gradually would extend coverage to nearly all Americans by providing government subsidies to help pay premiums. The measures would bar insurers' practices such as charging more to those in poor health or denying them coverage altogether.

Meanwhile, Wisconsin lawmakers are taking their own strides to increase coverage for young adults.

A new state law taking effect Jan. 1 allows people up to age 27 to remain on their parents' health insurance plans unless they have access to cheaper plans through their employers.

Gov. Jim Doyle said he expects the law that passed as part of the state budget will help many young people who either can't afford health insurance when they first start working or aren't offered it.

The state had no estimates on how many people would be affected or what may happen to rates.

"In the meantime, I guess I'll just look carefully before I cross the street," said Zobjeck.

— Adam Rodewald: (920) 426-6632 or arodewal@gannett.com. The Associated Press contributed to this story.