What happens to under-26 and covered in the Delaware Valley if health law is overturned?
As the health care industry anxiously waits for a Supreme Court decision on the constitutionality of federal health law this week, many are playing the ‘what if?’ game, including young adults newly eligible for their parents’ health insurance plans until they turn 26.
In the Delaware Valley, the answer to that ‘what if?’ depends on where they live.
Mike Young, a health-care expert with Buck Consultants, said he predicts if the entire law is overturned, a big if, companies will do one of three things.
“I think you’ll have some that basically just kick the dependent kids out of the plan,” Young said, though many will likely wait until the next plan year.
Others, he predicts, will allow young adults already covered to stay grandfathered in the plans, but stop accepting new applicants.
Finally, Young believes some insurers will continue to cover adults up to age 26.
“I think you’re going to have some employers who have seen this as a positive step for their employees,even through there has been an additional 1 to 2 percent increase in cost in an employers healthcare plan,” Young said.
But laws in more than 30 states extend eligibility ages beyond old federal standards independent of the health law.
Those laws, says Ballard Spahr health law expert Brian Pinheiro, will not change no matter the outcome of the health ruling this week.
“If it’s overturned in its entirety,” Pinheiro said, “that doesn’t do anything to any of the state laws,”
That means childless, unmarried, otherwise uninsured children in New Jersey will continue to be covered on their parents’ group health insurance plans until age 31 if they live in the state or are in school. And in Delaware, with a similar set of restrictions, that is true until age 24.
The requirements don’t apply to young adults whose parents work at certain large companies that self-insure, which are not subject to state laws.
In Pennsylvania, Pinheiro said, coverage requirements would default back to old federal standards — age 19 or 23 for students.
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