Kelly Hardy and Robert Phillips respond to some frequently asked questions on the impact of the health care law on children. Hardy is director of health policy at Children Now, a national organization that helps children achieve their full potential. And Phillips is the Director of Health & Human Services at the California Endowment a private, statewide health foundation whose mission is to expand access to affordable, quality health care for underserved individuals and communities, and to promote fundamental improvements in the health status of all Californians.
I am a 23-year-old college graduate working for a company that doesn’t provide health insurance. I got aged out of my dad’s insurance before I started college and can’t afford to buy private health insurance. Can the new health care reform law help me?
Yes! As of this September, young adults can stay on their parents’ family health insurance plans until they turn 26, even if they are not students or financially dependent on their parents. However, you can only re-join your parents’ plan if your employer doesn’t provide health coverage. Each insurance company has a different time of year when it enrolls new people on an existing insurance plan. So if your parents have an insurance plan that kicked you off or excluded you before September 23rd, your parents’ insurance company does not have to put you back on the plan before the start of the next plan year. For example, if your parent’s “plan year” does not start until January 2011, you may not get insurance coverage until then. You’ll have to check with your parent’s employer to know for sure if you are eligible for coverage now.
My son, now 20, was diagnosed with autism when he was three. It has been impossible for me to get him health insurance because most health plans do not cover mental health. Does the new health law address situations such as mine?
Starting in 2014, the federal health reform law requires mental health services to be included as a benefit in health insurance plans provided through the health care Exchange networks being set up in each state. Also in 2014, mental illness can no longer be used by insurers to deny coverage as a “pre-existing condition,” and insurers will not able to use mental health conditions to raise your premiums.
I have a 21-year-old daughter who has been diagnosed with Type 2 diabetes. My part-time job doesn’t provide health insurance, and I make a little too much to qualify for Medi-Cal. No insurance company will cover my daughter because of her pre-existing condition. Can I get relief from the new health care law?
In September 2010, the health care law provision preventing insurance companies from denying coverage to children (18-years and younger) based on pre-existing conditions went into effect. In 2014, this provision will cover Americans of all ages. The new law also provides funding for insurance for those with pre-existing conditions. This program is available for individuals who have not had health coverage in the six months prior to applying.
A health insurance company recently refused to sell me a child-only policy for my 7-year-old child, who is healthy right now. But I want her to have insurance, just in case. I was told that insurance companies are doing this because of the new health care reform law. Can they do this?
Unfortunately, some insurers have decided to stop offering child-only policies to new customers. Existing customers are not impacted. This affects a small number of children, but often these are the children most in need. The situation will be improved in 2014, when all insurers who wish to participate in state Exchanges will be required to offer child-only policies. In the meantime, a new California law that goes into effect next January prohibits insurers from participating in California’s Exchange for five years if they stop offering child-only policies.
If you have any questions about the health care law, call: (800)-871-9012 x 712389#, or e-mail your question to [email protected] or send by regular mail to P.O. Box 410447, San Francisco, CA 94141-0447. You can find more resources at www.calendow.org/healthlaw.