ACA dependent insurance quesiton

nicolen08 · January 2014

This has to do with money, so perhaps someone on this forum would know the answer to this question:

Under the affordable care act, can a dependent child remain on their parents insurance until age 26, if they are married and have coverage through their spouses employer but they are not eligible for coverage under their own employer?

I know that insurance companies must cover dependent children under 26 even if they are married and have an offer of insurance through their own employer. But, I'm still not sure if they can have dual coverage or if it matters if their offer of alternate coverage is through a spouse or their own employer.

Thank you to anyone who knows. I'm going to read the actual ACA to try and figure this out. When I call my insurance company they are clueless and give me a different answer every time.

hoffse · January 2014

Historically, the answer to this is no- but I think the ACA changed part of this. I know my H had to get off of his mother's insurance when we got married in April, even though he was still 25 at the time. He couldn't stay on it as a dependent, since he was eligible to be covered under my insurance after our wedding.

Also - historically, a "dependent" rare includes a married child. For instance, you can't claim a married child on your tax return if they file jointly with their spouse. Otherwise that child would be counted twice, and marriage trumps parenthood in the hierarchy of tax returns.

So I could see it either way - on the one hand, this rule might jive with IRS definitions of a dependent... on the other hand, I suspect Congress may have ignored some pretty major components of the tax code when they wrote that law. And it's not like any of them actually read the thing before voting on it anyway.

Sorry I'm not more help. I'm pretty sure you are correct in that you can now have married children stay on parents' insurance until the age of 26 (which completely outrages me, but whatever - nobody asked me about that). But if they have alternate coverage through their spouse, I don't know if that changes the rule. It SHOULD. But that doesn't mean it does.

I wish you the best of luck in trying to read the actual ACA. Every time I start, I get disgusted and sort of start to twitch - so I have never made it more than a few pages in. My law school roommate actually had a 13-page excerpt of the ACA on her constitutional law exam... and the prompt said, "Analyze and discuss all of the constitutional problems in the following document." It was a 4-hour exam, and that was the only question. And this was from a law professor who regularly testifies before Congress on healthcare policy and law.... and who also successfully argued his first constitutional law case in front of the US Supreme Court at the age of 27. The man is literally the reason cities can't prohibit newspapers from being distributed on street corners. So yeah. The whole ACA makes me - and a lot of other lawyers I know - prickly

I think SCOTUS completely caved on that one.

nicolen08 · January 2014

hahaha. So much hate for the ACA.

For the ACA, "dependent" is defined differently. It just means that you're a child of the parent. Financial or marital status isn't considered, and your parent does not have to claim you as a dependent for it to apply. So, the use of the word "dependent" is misleading because it makes one think of the way the term is used under the tax code.

I'm not a lawyer by choice, but I do have a JD (maybe you could tell from my "issue" statement HA), and I LOVE the ACA. haha I have a serious chronic illness and thank goodness for the ACA because now I cannot be denied coverage due to my preexisting condition or reach a lifetime limit on my care, which includes drugs that can cost over $25,000 per year. For the record, I also supported it before I was diagnosed.

And, I totally respect people with different views, and I love hearing different views on it or any other subject.

nicolen08 · January 2014

So, I called the helpline at healthcare.gov, and I was immediately connected to a sweet young woman who told me she is 100% sure you can have DUAL coverage until you are 26. It does not matter whether the second coverage is through your own employer or through a spouse's employer. She said she knows this for sure because she has dual coverage through her parents and her work.

So, for anyone who cares to know this information, I think this is the correct answer. I gave up reading the ACA. hahaha. Too convoluted, and I was probably missing some pertinent amendment that got passed, making most of my reading futile anyway.

hoffse · January 2014

Good to know, OP. I'm sure that's a question that's going to come up again.

I don't mind some parts of the ACA (like the pre-existing condition thing) - I do think that healthcare was an important issue to address, but I think they went about it badly. I dislike treating insurance like something that's prepaid on the whole. To me, insurance is something you use as a last resort. I prefer the very high deductible/very low premium route with maybe MAYBE an annual exam covered. Getting to where it's mandatory to cover things like birth control is just ridiculous IMO. That sort of stuff really doesn't affect overall health, and all it does is increase the cost of insurance for everybody. I think we can all come up with a less expensive way to not get pregnant... like, don't have sex.

It also really bothers me that there isn't really consumer choice about whether to purchase insurance or not. That was entirely unprecedented, and it seemed to me that pretty much every constitutional case on both the commerce side of things and the tax/spending side of things should have led SCOTUS to the opposite conclusion. There were ways to write the law to make it constitutional, and I just think they were lazy about it.

I wish Congress had spent more time tackling the costs of healthcare, rather than over-regulating insurance, because access to healthcare IS a big problem in the US. One reason insurance premiums are so high is because costs have just absolutely spiraled out of control. I honestly don't know that the ACA is really going to solve all these problems. Insurance companies now have to cover so much under every type of plan, that even HSA premiums are going to be wildly expensive for many people. My new employer's HSA (which complies with the ACA) costs $300 per month for an individual. And then the deductible is another $2,500 on top of the crazy premiums. So whether I go to the doctor or not, I'm spending at least $3600 per year on health insurance, before I begin to fund my HSA. In contrast, my H's catastrophic policy from 2013 cost $43 per month with a $7,000 deductible. He typically consumes about $100 per year in health costs, which we just pay for out of pocket. We really bought that policy in case he was in a car wreck. So I'm concerned that it's going to cause a lot of financial problems for the middle class since even the "cheap" plans have to cover so much. Oh well, as I said, nobody asked me

nicolen08 · January 2014

Well, I understand your positions and why you feel annoyed at the individual mandate. But, without it, insurance companies would just be paying for all the sick people while the healthy people opted out, so that's why it's there. Definitely, if there is a better way to give everyone coverage without adding expense to healthy people then we should do that, but as of now, no one has really come up with a better way. Could we debate more as a nation and find a better way? Maybe. But all the while people would be ill and not receiving adequate care.

So, it's not perfect, but it's an amazing start. And I'm glad it passed rather than having people suffer longer while we tried to come up with some nearly perfect solution. It will be refined more and more as we continue to debate it as a nation, but many ill people now have a hope of gaining a better quality of life and if that means that we all pay more, so be it. It's not like people who have to opt-in get nothing. They get more comprehensive health coverage. Anyone could wake up tomorrow with a serious chronic illness, and then they will be thankful for being forced to get coverage. I'm not usually a fan of the government making people do things, but I feel differently when it comes to health care.

And, it's just not realistic to prevent pregnancy with abstinence. I'd rather a girl be given free birth control than support her and her baby on welfare.

Definitely, health care is way too expensive and costs need to be controlled. But while we work on that, people should have access to care, like they do now, and no one should go bankrupt because they were diagnosed with cancer or some other terrible illness. Costs are high in part because the drugs a lot of people need are super expensive, and the drug companies have lobbyists fighting for them. Who do the sick people have? They needed a law like this to give them a chance at a normal life. Getting the drug companies to profit significantly less or restructuring our entire healthcare system to cut out all the red tape that creates extra costs is a crazy huge task. The ACA was the more realistic way of starting the change that needed to happen.

And, the middle class will feel the pinch when they pay more for healthcare. But, the middle class is suffering due to many serious problems with our overall economy. Let's fix all that stuff and then paying this extra amount for health care won't be a problem. Of course, none of our problems are easy to fix, but people need healthcare and they shouldn't have to wait until our country's economy is stronger to get it. We already have people profiting off lots of government programs/interventions, and the people who are left out should not be the sick, they need the help more than anyone.

But, no one asked me either. Hahaha. I love debating stuff like this.

Sisugal · January 2014

My tinfoil hat theory is that the ACA really is not about improving nor fixing healthcare - but is a means to get people to accept universal health care (The ACA is designed to fail).
It has a huge number of carve outs and exemptions to special groups who do not have to abide by the same rules and guidelines of the law.
There are now more people without insurance than before the ACA became law --- and this was supposed to get the uninusred insured?
This was a badly written bill
And yes, the Republicans do have a heath care plan, but you don't hear much about it. It includes some aspects of the ACA - pre existing conditions one of them. They have passed numerous bills in the house, but Harry Reid will not let them come to the floor for discussion much less a vote.

emily1004 · January 2014

Sisugal said:
There are now more people without insurance than before the ACA became law --- and this was supposed to get the uninusred insured?

How do you know this? The numbers won't be out until April.

Wulfgar · January 2014

@emily1004, most of the economists have been saying that more people have lost their coverage at the end of 2013 than will sign up for the ACA. I personally know some people who still can't afford health insurance because of the premiums. You also have to count the number of people who were moved to part time so that their employer doesn't have to offer them health insurance.

emily1004 · January 2014

Wulfgar said:

@emily1004, most of the economists have been saying that more people have lost their coverage at the end of 2013 than will sign up for the ACA. I personally know some people who still can't afford health insurance because of the premiums. You also have to count the number of people who were moved to part time so that their employer doesn't have to offer them health insurance.

Please show me where I can find this research.

vlagrl29 · January 2014

I know that 5 or so million lost their coverage as soon as ACA took affect. I heard the numbers report that 2 million have applied for ACA. Based on that I would say it's true. I just thought that was common sense. Wait until later this year when the predicted 40-50 million loose coverage in the corporate world...all hell will break loose.

vlagrl29 · January 2014

Sisugal said:

My tinfoil hat theory is that the ACA really is not about improving nor fixing healthcare - but is a means to get people to accept universal health care (The ACA is designed to fail).
It has a huge number of carve outs and exemptions to special groups who do not have to abide by the same rules and guidelines of the law.
There are now more people without insurance than before the ACA became law --- and this was supposed to get the uninusred insured?
This was a badly written bill
And yes, the Republicans do have a heath care plan, but you don't hear much about it. It includes some aspects of the ACA - pre existing conditions one of them. They have passed numerous bills in the house, but Harry Reid will not let them come to the floor for discussion much less a vote.

I love your straight to the point answers

emily1004 · January 2014

vlagrl29 said:

I know that 5 or so million lost their coverage as soon as ACA took affect. I heard the numbers report that 2 million have applied for ACA. Based on that I would say it's true. I just thought that was common sense. Wait until later this year when the predicted 40-50 million loose coverage in the corporate world...all hell will break loose.

But that's not entirely true. Those five million that were told their policies were going to be cancelled, were cancelled, but they did not lose coverage. If they did not pick a new policy by the end of the year they were grandfathered into one that followed the law. None of those five million are without coverage. It's called a catastrophic policy. Plus you didn't have to sign up on the ACA website, you could go to the insurance company itself. I am just looking for information that includes the actual stats.

ACA dependent insurance quesiton

Re: ACA dependent insurance quesiton

Choose Another Board

Search Boards