<p>SamuraiLandshark: </p>
<p>Under ACA, there are multiple options for a young person age 18-26:</p>
<p>1) The person can remain in the parent’s insurance policy, up through age 26, whether or not living at home, or whether or not a dependent. If the young person has a taxable income, that income will be include in calculating household income for purposes of subsidies, and household size will be determined counting that person. </p>
<p>2) The young person can buy a separate policy, in whatever state he lives (including the home state of the person). If the young person is still claimed as a dependent of the parents, the young person will NOT be eligible for a subsidy on the exchange, but is free to buy the policy at full cost, or to purchase a policy directly from an insurer. </p>
<p>3) The young person can get insurance through an employer, if available.</p>
<p>4) If the young person is financially independent of the parents – NOT a dependent for tax purposes, and has a personal income of below 138% of the poverty line, the young person can get Medicaid, if he lives in one of the states that expanded medicaid.</p>
<p>5) If the young person is a college student, he can also opt to buy insurance offered via his university. </p>
<p>Bottom line: under ACA, the person age 18-26 has more choices than ever before. </p>
<p>A parent who posted upthread had a concern because the daughter had a history of a serious and recurrent medical condition. Before passage of ACA, that child would have been virtually uninsurable via the private market – unless the parents had been lucky enough to be able to hold onto a policy issued before the first diagnosis. It is likely that the insurance rates would have been very high as well. However, when the ACA was passed, the prohibition on excluding children for pre-existing conditions was effective immediately, so the parents would have been able to buy a new policy including the daughter from 2011 going forward. Now, as noted, if the daughter goes out of state to college, they will have the opportunity to choose from any policy offered in the destination state. The daughter will pay the same rate as any other 18 year old.</p>
<p>It is probably more confusing for the parents than it was in the past, but that confusion stems from the fact that they actually have an array of different choices. Five years ago, if they received a cancellation notice from their insurance company, for whatever reason – they probably would have found it impossible to insure their daughter at any cost. When the daughter went off to college, they’d opt for the college plan – even if it was skimpy - because that would be what was available without medical underwriting. </p>
<p>I advised a wait-and-see approach simply because they don’t know where their daughter will be attending school in the fall. If the daughter had an ED admission in hand, they could begin to do some research about that particular state and college – but without that information, it’s just not worth the effort to do that much advance planning. </p>
<p>Another option they have is to keep their daughter on the in-state plan through 2014, knowing that the daughter is entitled to emergency care in any state on that plan, and simply wait until the next open enrollment period before considering any change.</p>