Insurers Don’t Have To Offer Extended Young Adult Coverage Unless They Want To

[Donnachaidh]

http://news.firedoglake.com/2010/05/10/insurers-dont-have-to-offer-extended-young-adult-coverage-unless-they-want-to/


The Department of Health and Human Services has helpfully pointed out to insurance companies how they can avoid the requirement that dependents can stay on their parent’s policies until the age of 26:

“The new policy applies only to health insurance plans that offer dependent coverage in the first place: while most insurers and employer-sponsored plans offer dependent coverage, there is no requirement to do so,” the Department of Health and Human Services said in a statement Monday.

In addition, families can be charged more for coverage of the young adult to the extent “similarly situated” individuals can be required to pay more under their health plan, HHS said. The young adults must be offered all of the benefit packages available to “similarly situated” individuals who did not lose coverage because their dependent status ended, HHS said.

I’m assuming that the second paragraph means that a dependent who smokes can be charged more, or that before the community rating laws kick in by 2014, any medical history can result in a sharp increase in rates.

But really insurance companies – or self-insured large corporations – don’t have to price young adults off their parent’s policies. According to the rule, they can simply not offer dependent coverage, and that, as they say, is that. While several insurers have actually said they would accelerate the extended coverage and start it in the coming weeks, rather than the September start date the Affordable Care Act mandates, the article points out that self-insured corporations haven’t embraced that concept. Indeed, they would rather avoid taking on more potentially sick customers onto their current insurance plans, even if young adults aged 18-26 are relatively inexpensive to insure. And nothing in the law would force them to do so, backed up by HHS’s rulemaking.

More at the link ---

[ixion]

1. HC'R' = epic fail

'nuff said.

[Aramchek]

3. tell that to the children who don't have to depend on Donation jars for treatment any more

because they can now get insurance.

[avaistheone1]

7. Don't throw away the donations jars just yet.

There will continue to be over 24,000 deaths per year for those who are not eligible for HCR, and do not have access do insurance.

Yes, some of these humans will be even be children.

[ixion]

22. health insurance is not health care

there is an enormous difference.

[TransitJohn]

30. Both of them. n/t

n/t

[Coyote_Bandit]

9. +1,000,000

But we sure like to pretend that it will be a grand success.

Passing that piece of shit legislation was a fucking political accomplishment. Nothing more.

There will still be millions without meaningful access to healthcare. There will still be people dying because they can't secure meaningful care. And some of them will get to face penalties for the privilege of going without that care.

[OhioChick]

29. Bingo n/t

[Aramchek]

2. just keep banging your head up against the wall

can't you see that HCR is Law now?

you aren't going to change that fact.

[avaistheone1]

4. And you aren't going to check the fact that the health insurance industry will exploit any

loophole they can find in the HCR law. And where there isn't a loophole they will create one and then make sure none of their bought and paid for members of the Congress and Senate hold them accountable for it.

[Aramchek]

8. you don't want HCR to be successful. face it.

you don't have any cases where kids have been denied the extension, only hypotheticals.
but that seems to be enough for you to scream DOOM!!!

[MadHound]

15. No, actually those of us who were critical of HCR did want it to succeed,

However what we were critical of is how the legislation was stripped of provisions that would allow it to succeed, how loopholes were added that would allow it to fail, and how in general the bill, now law, became nothing more than a gift to the insurance industry.

What I'm wondering now, with cracks such as the one detailed in the OP, is whether the supporters who pushed for this monstrosity will admit their mistake as it becomes increasingly obvious that this is bad law.

Somehow I doubt it. I imagine in four, five years there will be nobody on this board who will ever admit to supporting HCR.

[Aramchek]

19. you don't have much of an imagination

[Raineyb]

21. Funny how people were saying that things like this would happen BEFORE this bill passed and was

shouted down.

And it hasn't even gone into effect and yet here's the second publicized screwing of the public out for perusal. But people would have you think this bill was the greatest thing since sliced bread.

[TransitJohn]

31. Don't you know that chess games take four or five years?

:evilfrown: :hide:

[robinblue]

33. Well said.

[Ignis]

24. Hey look, another person with Telepathy!

Normal folks like myself would have to read and analyze what others have written, rather than simply digging into their brains and determining what they REALLY think.

Gosh, it must be helpful to just KNOW what a poster's values and thoughts are!

:eyes:

[Warren Stupidity]

5. Insurance companies selling plans with dependent coverage

will be required to cover adult children up to age 26. That is the law. Obviously this does not apply to individual insurance plans that only cover an individual. And yes, the coverage is not free, it is priced as all other coverage will be priced.

[jody]

6. Why shouldn't parents pay the added cost of those adult dependents? n/t

[michaz]

25. Not saying we shouldn't but why have to pay this much more than we are now?

Our daughter graduates from college this month and the insurance company told us that she will be off our insurance June 1st. We have a family plan and have had for years for which we now pay $500 per month for. My husband is a retired teacher so part of his and mine are paid for by the school district (our part is the $500.) They said they had not been informed of any info from the administration as yet and that if we wanted our daughter to stay on the policy it would cost us another $500 per month for her. Her part of the $500 we pay now is $162. So I don't think we are seeing much of a deal with this new reform! And of course, with the employment situation the way it is I am not to optimistic about her finding a job that is going to offer her insurance. Yup, I am real impressed!

[jody]

26. I don't see how competition can drive your cost lower given the apparent govt. control over the

programs.

Like others, I don't believe health care costs will be lower under HCR nor an improvement in quality.

True that more will be covered but I don't trust planners to do any better job of managing health care than BP has done with its drilling operations or the Russians did with Chernobyl or presidents have done fighting the Taliban.

[michaz]

27. If it worked for the additional $162 to insure her for all these years

(and it does go up and down over the years) not sure why it needs to now be at $500. We don't expect it to go down, but we do expect she could stay covered at the cost it has been.

[HCompare]

34. Restructuring your plan, or putting your daughter on a separate plan may help

With regard to your daughter coming off your Health insurance plan in June or costing you an extra $500 per month, you could consider taking her off the family plan and arranging a separate insurance for her. Her age suggests she may be able to qualify for a lower premium, or, if she is in good health, you can consider a plan with a higher deductible, or one that covers her immediate needs plus any catastrophic coverage. This may be better than restructuring your family plan, especially if you and your husband have concerns around not qualifying for a new policy. For transparency, I work with http://www.HealthCompare.com a health insurance exchange. Understanding the market, I know there are some good plans out there that may be suitable. Good luck in your search and congratulations on the graduation.

[BzaDem]

10. Is this not obvious? They have never been required to cover dependents.

Most do so because they are the cheapest to insure. This doesn't change now that the age is raised to 26. How is this earth-shaking news? Did people expect companies that insurance company dependent coverage be mandated? While that may be a fine policy, I've never heard it advertised.

[Xithras]

11. They just noticed? This was discussed extensively before HCR even passed.

The law merely extends coverage to age 26. Adult dependent coverage has ALWAYS been a "courtesy" that the companies extend to their policyholders, and there isn't a single federal or state law that requires it.

And even if there was, there isn't a single federal or state law that would require parents to fork over the money anyway.

And lets not even get into the fact that the law requires an extension of insurance until age 26, but the average American woman has her first child at age 24. Not only will the child not be covered by the grandparents policy, but the law now states that the insurance may be completely cut of upon marriage, so we can expect a spike in unmarried births.

Or the fact that, if you've been off your parents plan for more than 63 days and have a pre-existing condition, they can deny you coverage until 2014 anyway.

Or, as one on my students pointed out recently, how it now gives parents the ability to tell their adult children, "You will do what I say, or I will cut you off from my insurance and you will be forced to spend huge sums of your own money on insurance", thereby giving parents economic leverage over their grown children.

Yes, there are side effects. Lots of them. Some of them are REALLY bad, and others merely annoyances. The REAL question is whether the net benefits of the bill is great enough to justify all of the problems.

Nobody should be suprised by the flaws though. The fact that the bill was written by insurance company reps was never exactly a secret. They wrote a law that would extend coverage to most Americans, while minimizing their own financial risk and maximizing potential profit margins. That's how America works.

[Raineyb]

12. Oh look another loophole.

Who'd a thunk it?

[ProSense]

13. It's not a loophole.

This is just another attempt to generate outrage.

[Name removed]

16. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Name removed]

18. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Raineyb]

20. When you sell something as covering everyone and it doesn't actually do so

People tend to see it as a loophole. Your refusal to take note of that is, unsurprising.

[ProSense]

28. Dependent coverage has nothing to do with whether or not the bill covers everyone.

Absolutely nothing.

[pnwmom]

14. You should have said: "Unless they offer dependent coverage." The bill doesn't adda new requirement

to offer dependent coverage; it just raises the maximum age of dependents.

[Dr Morbius]

17. Hopefully, competition will make insurers "want to",

But I understand if people don't think it will actually happen. I myself am hoping for a fix of the bill, either in the next Congress or the one after; it's clear we're not getting anything better out of Congress until there's a change of personnel. There's still time before 2014.

[amborin]

23. K&R

[BlueIris]

32. Read up.

I hope everyone living in the world of denial about HCR reads these articles and thinks about their significance.