Even as members of the Obama administration and Congress met Thursday to try to find common ground on health care, a new report warned that without comprehensive legislation, more than 275,000 adults nationwide would die over the next decade because of a lack of health insurance. Nearly 14,000 of the deaths would occur in New York state, said the report, done by the liberal advocacy group Families USA. An earlier study by the Institute of Medicine estimated that 18,000 people died prematurely in 2000 because they lacked insurance; the Urban Institute updated that figure to 22,000 in 2006. The new study applied the methodology used in the previous reports to calculate, on both a national and state-by-state basis, the latest figures. The new report estimates that 68 adults under age 65 die prematurely every day because they do not have coverage. Absent a significant change in coverage rates, the figure will climb to 84 by 2019, the study projects. Experts say uninsured people are more likely to skip screenings and other preventive care, so their medical problems are often diagnosed later, when they are more advanced and harder to treat. The uninsured are also more likely to skimp on necessary medical care. 'The bottom line is that if you don't get a disease picked up early and you don't get necessary treatment, you're more likely to die,' said Stan Dorn, a senior fellow at the Urban Institute, which has published similar data. MORE FRUGAL THAN RECKLESS Better health does not seem to explain why so many young people forgo health insurance. Rather, income does, according to new survey data released by Gallup. One of the explanations for rising health care costs is that relatively healthy people are taking their chances and going without insurance. The relatively sick pool of insured customers who are left drives up the cost of premiums, at least if there is any form of risk-sharing (like community rating) within that pool. This drives out the healthiest people who are willing to take their chances, which drives the cost of premiums up further, and so on. This is sometimes referred to as the 'death spiral' of health insurance. Young adults are significantly less likely to have health insurance than their older counterparts. The percentage of people with health insurance troughs at age 22, when just 66 percent of Americans are covered. Many people assume that this is because young people are also less likely to have health problems than their older, presumably more infirm, peers. Perhaps young adults do not buy health insurance because they do not think they will need it. That would be a relatively rational conclusion for young people to make, statistically speaking. But if you look a little closer at health insurance purchases among young people alone, this demographic actually appears more risk-averse about their health than is commonly believed. In fact, last year, healthy young adults were much more likely to have health insurance than their sicker peers, according to Gallup. It appears to be affordability, not recklessness (or even rational cost-benefit analysis of health risk), that is driving young people away from insurance policies. Among young adults, 86 percent of those in the top third of the income distribution (people earning $48,000 or more annually) have health insurance. In the middle third (those earning $24,000 to $48,000), 72 percent have health insurance. And in the bottom third (those making less than $24,000), just 58 percent are on a health plan. One policy implication: Cheaper health premiums might encourage more young people to buy insurance without a mandate to do so. -- CATHERINE RAMPELL 