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A Health Reform Q&A with Health Secretary Kathleen Sebelius

How the New Affordable Care Act Affects Parents

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A Health Reform Q&A with Health Secretary Kathleen Sebelius

Kathleen Sebelius, U.S. Secretary of Health and Human Services

Photo by Alex Wong, Getty Images

The 2010 Affordable Care Act will have a profound impact on U.S. families with young adults, who are notoriously underinsured. Young adults, ages 18-26, are the least likely to have full-time jobs that include health insurance. One in six has a chronic health condition, such as asthma, cancer or diabetes. And even those who go to college, which allows their parents to keep them on the family insurance plan, find themselves insurance-less on graduation day. In short, some 30% of young adults do not have health coverage of any kind. It’s untenable, says Kathleen Sebelius, President Barack Obama’s Secretary of Health and Human Services. All it takes is one accident or one health crisis to push them – and their parents – into bankruptcy.

“For years, getting a diploma also meant losing your health insurance,” Sebelius said in a May 10, 2010 post on her White House blog. “And whether you went on to college or not, it was often hard as a young person to find affordable coverage. Overall, Americans in their twenties were twice as likely to go without health insurance as older Americans. I saw this firsthand as a mom.”

Under the new health reform legislation, which takes effect September 23, 2010, parents will be able to keep their grown children on their family’s health insurance plan up to age 26.

I joined three other About.com guides - to college life, health insurance and patient empowerment - in a conference call with Sebelius on May 11, so we could discuss the new legislation and what it means for families. Here is what she had to say:

Q: In the past, parents could not keep their grad students or other non-dependent 20somethings on their health insurance plans. How does the reform bill affect dependents vs. non-dependents?

A: “What the new bill does is redefine dependency to include anyone’s child or stepchild, up to 26 years old,” Sebelius says. “It’s no longer tied to full time students or aging out. It opens plans to people who have been knocked off (their parents’ insurance) by college graduation or a certain birthday.”

Q: The new bill goes into effect in September, but my child is graduating now. What now?

A: Every major insurance company – more than 65, including Blue Cross, Aetna and Kaiser – and several major self-insured companies have pledged to provide gap coverage this summer. Sebelius calls it "great news for graduating seniors and their families," and says premiums are expected to rise by just 0.7%.

Q: Most insurance is based on managed care plans. What if my college student or 20something doesn’t live in the same city or state as his family?

A: Check with your insurance provider, says Sebelius, “Every plan has slightly different provisions, but lots of plans have companion programs in other states – Blue Cross is in Maine and California and New York. There are out-of-network providers. It’s not unusual to have plans in place for travel and school.”

Q: What about students with pre-existing conditions? Children are covered - and by 2014, everyone with pre-existing conditions will be - but now?

A: Sebelius recommends checking with your insurer and state insurance commissioner, as the transition progresses. The idea is that the new insurance marketplace will include a high-risk pool.

Q: What about married 20somethings?

A: The policy applies to married young adults, as well as single ones, but not your child’s spouse nor their children.

Q: What do we need to do now?

A: Ask your insurance company about your options now, whether your child is just graduating or has already been dropped from your policy. If your employer or insurance company does not offer gap coverage, watch for special open enrollment notices around September 23, 2010, when the new plan goes into effect.

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