October 1, 2009: Young adults between the ages of 19 and 26 are the more likely than any other age group in the United States to lack insurance coverage. These young adults usually lose insurance as they age out of their parents' insurance plans or graduate from college and then enter a workforce that often does not provide health insurance to its newest workers. Some insurance plans may continue to provide coverage for this age group under the umbrella of dependent coverage, but under many plans, this group no longer meets the criteria for "eligible dependents."
Currently, there is no federal statute that defines "dependent," but some national health reform proposals would create such a definition and, in doing so, would expand the industry standard beyond 18 years of age. In particular, the Senate Health, Education, Labor, and Pension (HELP) Committee's Affordable Health Choices Act (H.R. 3200) would extend dependent coverage to children up to age 26 for all individual and group policies. (Click here to view the text of H.R. 3200.)
Until federal action is taken on the issue of defining depending coverage, the states are left to determine the issue on their own. State laws vary widely in their definitions of who counts as a dependent. Some states allow insurance plans to abide by internal definitions of "dependent," while other states mandate certain standards for dependent coverage for fully insured plans and individual insurance policies. In some cases, states have expanded the definition of dependent coverage to include older children up to 25 or 30 years old, along with elderly/impaired parents being cared for by their children. The varied experiences of these states can provide lessons for those considering such expansions at both the state and federal level. To that end, SHARE has released a new report summarizing states' efforts to define and expand dependent coverage and detailing the new "dependent" classifications that have been established. To view this new report, click here.
SHARE Grantee Joel Cantor, Sc.D., of Rutgers University, is studying the potential impact of dependent coverage expansions on young adult coverage rates.
- Click here to learn more about Joel's SHARE project.
- Click here to view slides from Joel's June 2009 presentation of preliminary findings, where he reveals that expanded dependent coverage appears to substitute for other coverage, resulting in zero net change in overall coverage rates.