Three Cheers for Dependent Coverage Expansion!

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By Patrick Tigue, New England Alliance for Children's Health

While there are many provisions in the Affordable Care Act (ACA) that will benefit children and families, the expansion of dependent coverage to children up to age 26 is among the most important - especially in the short-term. In 2011 alone, as many as 1.64 million previously uninsured young adults are estimated to gain coverage under their parents' health plans. The provision takes effect after September 23, 2010.

Recently, the federal government issued regulations further explaining how this provision will work. Here at the New England Alliance for Children's Health, an initiative of Community Catalyst, we support these regulations because they clarify several important points that will benefit young adults and apply the law with their interests at heart:

  • Young adults are eligible for coverage under their parents' plan regardless of what state they live in and whether they are tax dependent, financially independent, or a student, employed, or married.
  • Premiums or benefits cannot vary based on the age of a young adult who qualifies as a dependent.
  • The provision applies to all health plans and only grandfathered health plans (those in existence prior to March 23, 2010) can exclude young adults with access to an employer-sponsored plan until 2014. After 2014, this exception no longer applies.
  • Insurance companies must provide prominent notice to enrollees about the special enrollment period for dependents.
  • States have the option to extend dependent coverage beyond age 26.

All of these clarifications and others included in the regulations will ensure that dependent children and their families can take full advantage of this important opportunity to secure the health coverage they need.

While we are enthusiastic about the regulations, we've also been working collaboratively with a group of our partners to offer some suggestions to the federal government on how to improve them in a few key areas:

  • Clarify that stepchildren and adopted children are included in the definition of a dependent child.
  • Further explain the situations where grandfathered plans can remove young adults who are eligible for employer-sponsored insurance to ensure that this does not unduly burden young adults.
  • Require that prominent notice be clear and conspicuous--ideally in the form of a stand-alone document highlighting the availability of the new coverage option and how to enroll.

It's our hope that the regulations will be revised soon to reflect these suggestions, but in the meantime you can find out more about the dependent coverage expansion here. This provision is one of the many examples of the very real opportunities that ACA provides to extend coverage to those who otherwise would go without.

This blog post was originally posted on the Health Policy Hub.  The views expressed by Guest Bloggers do not necessarily reflect the views of the Center for Children and Families.

Editor's Note:  CCF also submitted comments on the dependent coverage regulations which you can read here.  

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