Three Major Ways the ACA helps Young Adults with Special Health Care Needs

Many children with special health care needs and their families rely on the support of state and federal government programs or benefits to allow them to get the care they need. Without this governmental support, many of these children and young adults would be unable to go to school; their parents would be unable to work, or to live healthy lives. As children transition to adulthood, many of these support systems and benefits fall away. Most of these programs are offered only to children. In order to keep getting the care they rely on, these kids must attempt to find adult programs that offer similar benefits. Due to the differences in programs, as well as differences in eligibility criteria, many of these disabled young adults end up going without much of the care they would need to become healthy, integrated members of society. Needless to say, the process of transitioning from childhood to adulthood is a complicated and confusing one.

How will the ACA change the situation of “transition-age youth”?

1. Dependent Coverage: The ACA mandates that insurance companies must let kids remain covered by their parents’ health insurance up until age 26. For disabled young adults who have insured parents, this is good news. Many children with disabilities receive health care through programs offered only to children, so when those programs come to an end typically at age 19, they lose insurance coverage. Coverage under a parent’s insurance until age 26 would give the family time to secure other insurance options for their disabled child.

2. New Insurance Purchasing Power: Starting in 2014, health insurance companies will no longer be able to deny coverage due to a pre-existing condition, a problem that has caused many issues for transition-age youth with a history of pre-existing conditions looking to purchase insurance.. Additionally, the state health benefits exchanges will begin operations in 2014. These exchanges are predicted to create a consumer-friendly marketplace for individuals and families to purchase insurance options. Tax credits will be offered to citizens between 133-400% of the Federal Poverty Level, in order to offset the costs of plan premiums. So, a transition-age youth or the family of a disabled child looking to purchase insurance will have new consumer powers and protections to aid in doing so.

3. An Expanded Safety Net: The Medicaid expansion will begin January 1, 2014. Under the expansion, all adults with income below 133% of the federal poverty level will become eligible for Medicaid benefits. Often, children who are eligible for Medicaid due to a disability as a child are no longer eligible when judged by the different disability criteria that are applied to adults. The expansion will allow many disabled transition-age youth to keep their Medicaid benefits, regardless of their disability status.

Ensuring Young Adults’ Coverage Now Saves Us All Money Down the Line

Because of the Affordable Care Act, millions of Americans now have access to affordable health care and millions more will soon have coverage, as well. One group of Americans that is especially benefiting from our new law is young adults.

According to the Obama administration, 2.5 million previously uninsured young adults ages 19 through 25 are now covered. The majority of those who have recently gained coverage took advantage of a provision in the Affordable Care Act that allows young adults to stay on their parents’ plan until age 26.

Historically, young adults have been the age group most likely to go without health insurance. Almost 28 percent of 18- to 25-year-olds were uninsured in 2010 compared to only 9.8 percent of children under 18 years of age and 20.5 percent of 26- to 64-year-olds. For young adults, the recession hit particularly hard.

In fact, many recent college graduates had a hard time finding a job with health insurance, or finding a job at all. As a result, even more young adults went without health coverage.

Thanks to the health reform law, young adults no longer have to take this gamble. And, millions of parents have peace of mind, knowing that their young adult children will get good, affordable health care when they need it. For millions of parents around the country, this provides a huge sigh of relief:

They don’t have to worry about going bankrupt if disaster strikes and their child winds up in the emergency room with piles and piles of costly medical bills.

Insuring young adults is not only good for parents and kids; it’s good for us all. Because young adults are typically healthier and are less likely to need expensive medical services, their presence in the insurance pool means that costs for everyone are lower.

Without health reform, millions of young adults would be uninsured once they left college or even high school and the costs of their health care would ultimately be paid for by the insured when they eventually do seek medical attention.

Ensuring young adults are covered now saves us all money down the line and gives parents and their kids the peace of mind that they’ll have coverage they can count on when they need it the most.

By Ron Pollack
Originally posted here on the Health Insurance Resource Center
Ron Pollack is the Founding Executive Director of Families USA, the national organization working to achieve high-quality, affordable health coverage for everyone in the U.S. The Hill, a weekly newspaper covering Congress, named Mr. Pollack one of the nine top nonprofit lobbyists. Modern Healthcare named him one of the 100 Most Powerful People in Health Care.

Thank You, Affordable Care Act! The Importance of the Act’s Provision Allowing Young Adults to Keep Family Insurance

Before last year, the number of young adults going without health insurance had reached crisis levels. In 2009, nearly 15 million young adults between the ages of 19 and 29 lacked health insurance, 4 million more than a decade earlier.  After being covered as children, these young adults mostly lost coverage when they were kicked off their parents’ insurance plans after college or at age 20, 21 or 22, depending on the insurance company, or after they aged out of Medicaid or SCHIP programs. After losing that coverage, they could not afford to purchase their own insurance on the open market, being unemployed, in low-paying jobs without benefits or in school and without coverage. 

Had it not been for the passage of the Affordable Care Act (ACA) last year, the number of uninsured young adults would have continued to grow. As an unemployed, recent college graduate, I would most likely have been one of the newly uninsured in 2010 or had to pay for drastically more expensive coverage on my own.

Thankfully, the ACA’s provision mandating that insurers allow children up to age 26 to remain on their parents’ insurance has allowed me and thousands of young adults like me to remain covered. It scares me to think about what would have happened had I been forced to remain uninsured after I graduated. I have only had minor medical problems over the last year, but an accident or other serious malady would have been financially ruinous. Even if I had foregone the treatment of a small problem to save money, the problem could have developed into a much larger one.

However, other young adults with more serious health issues have benefited from this ACA provision more than me. My friends who have remained on their families’ insurance and who have chronic conditions, especially mental health conditions, are particularly benefiting from not having to discontinue their care. Even those who might have been able to buy more expensive coverage if forced are benefiting from remaining on their parents’ plans and having to pay less.

At a time when it is particularly risky to be young in America, this new coverage is particularly important. Because of the economic recession, unemployment amongst the young is increasing rapidly. According to economist and New York Times columnist Paul Krugman, of college graduates with a bachelor’s degree not enrolled in further schooling, only 74% had a full-time job in December of 2010, down from 83% in 2007.

Unemployment is already crippling both financially and psychologically, especially for the young; I am thankful that a lack of health insurance is less of a worry for my generation than it was before the ACA. The ACA will even continue to make coverage more affordable for my generation in the future with the expansion of Medicaid and the establishment of state health insurance exchanges. In my mind, expanding health insurance for young adults, especially allowing young adults to remain on parents’ plans, is one of the most significant achievements of the ACA and a demonstration of how health reform is already reshaping the healthcare landscape of America.

Emily Arntson
Intern, Health & Medicine Policy Research Group