Can Employer Health Plans Drop Employees’ Adult Children Whose Jobs Offer Coverage?

By Kaiser Health News Jun 25, 2014

Under the Affordable Care Act, health plans must allow adult children to stay on their parents’ plan until they turn 26 under most circumstances, even if the young adults are married or financially independent.

The law initially allowed one major exception for grandfathered plans—those that were in existence before the health law passed in March 2010 and hadn’t changed substantially since then. Those plans could refuse to cover adult children if they had an offer of employer-based coverage elsewhere, such as through their own jobs.

However, starting last January, that exception no longer applies. A 24-year-old should be able to remain on her father’s plan until she turns 26, even if her own job also offers health insurance.

The original provision, which went into effect six months after the law passed, was likely intended to ease the transition to new coverage rules for employer group plans, says Sara Collins, vice president at the Commonwealth Fund.

According to an FAQ from the Centers for Medicare & Medicaid Services, that was indeed the case. “Our goal is to cover as many young adults under the age of 26 as possible with the least amount of burden,” the document says.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente. © 2014 Kaiser Health News. All rights reserved. Republished with permission.

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