The cruel truth about dependent coverage

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President Obama and his team are in full campaign mode once again. They are telling America about all of the good things that the new health reform law will do for them this year. So, you may have heard this line recently “starting this year, for all of you students out there, if you don’t have insurance or if you are about to graduate and you’re not sure what your next job is going to be or there is a little gap between graduating and getting that job with insurance, all new plans and some current ones will allow you to stay on your parent’s insurance policy until you’re 26 years old, starting this year!” (emphasis added).

Well, that sounds fantastic, right? But, let’s look at the details that the president conveniently fails to mention: Until 2014, when health plans will be prohibited from charging higher premiums based on pre-existing conditions, insurers in the individual market can take into account a young adult’s medical history when calculating a family’s premium. And, the new plans are really the plans that will be sold in the state exchanges beginning in 2014. So, the key words in this statement are “some existing plans.” What does that mean?

There is no prohibition in the current law to prevent insurance companies from raising premiums on a family plan when an adult dependent is added to the policy. On Monday the Department of Health and Human Services released a statement that said the age extension “applies only to health insurance plans that offer dependant coverage in the first place: while most insurers and employer-sponsored plans offer dependent coverage, there is no requirement to do so.”

Is this a surprise? No, nothing is free. Extending the age at which an adult child can be added to a family policy might be of benefit to a few, but at what cost? No insurance company is going to provide this service for free, and this shouldn’t be expected. Until the state health insurance exchanges are fully operational and other provisions of the Patient Protection and Affordable Care Law begin to apply in 2014, the health insurance market will continue to operate in the same basic way that it did prior to the president’s signature on this bureaucratic monstrosity. And families will still be required to pay for extra services that a company provides. But, isn’t that the way business in supposed to work in a free economy? This should raise more than a few concerns about where we are really headed as our health care system begins to digest the details of this new law.

It is time that this administration began to tell the American public the truth about health care reform, without the spin. We do have to read this massive law to find out what is really in it.

Richard A. Armstrong MD FACS is on the Board of Directors of Docs4PatientCare.