<p>Your kid would be insured through the year end, but could not be re-enrolled in the next qualifying enrollment period. All exchange insurance is rated based on age at time of enrollment – not the age that people become during the year. (It could be different for policies purchased off the exchange, which would not necessarily be subject to the same enrollment period) </p>
<p>Cardinal Fang is right, the posters who wrote that it would be a qualifying event for a change in insurance are mistaken. The law does not talk about your child turning 26 – the legal phrasing instead refers to “child who has not attained age 27 as of the end of the taxable year.” (Here’s an IRS memo on the topic: <a href=“http://www.irs.gov/pub/irs-drop/n-10-38.pdf[/url]”>http://www.irs.gov/pub/irs-drop/n-10-38.pdf</a> )</p>
<p>Because the open enrollment periods in all future years close in December, then by definition any person who is not yet age 26 on January 1 will not have turned 27 by the end of the taxable year (Dec 31). </p>
<p>Think about it logically: all 25 year olds are bound to turn 26. So why write a law that requires routine insurance changes outside the open enrollment periods? That’s cumbersome and unnecessary – so instead, they word the law differently: the parent can’t insure any kid who will turn 27 by the end of the year. The net effect is the same – parent’s can buy insurance for children who are currently age 26. </p>
<p>Again, this doesn’t apply to off-exchange policies, which may have very different enrollment periods. So someone’s experience with their employer provided coverage might be very different.</p>
<p>Well thats true, but that kind of thing already went on. Usually the consumer complains that for all the money they are paying they should be able to go to what ever doctor they want. </p>
<p>What I am thinking of is deciding to have a medical procedure, or a test, at all based on its price. That goes on all the time when people are self pay, have catastrophic, or high deductible.</p>
<p>And it also goes on all the time when an insurance company decides it won’t pay for a procedure because the cost is unjustifiable for the results.</p>
<p>But also, take a look at the cost sharing in the Bronze and Silver plans. The consumer isn’t getting that health care for free; they have to pay.</p>
<p>I read an interesting opinion by a conservative health care economist; I’ll try to link if I run across it again. He was very much in favor of “skin in the game” for people making health care decisions. But he specifically excepted one group: poor people with chronic diseases. He said, for example, that we don’t want to put up any barriers at all that might encourage poor people with diabetes to skimp on their insulin, or skip their regular doctors’ appointments. Blindness and amputation, two common results of uncontrolled diabetes, are expensive. And they are also awful, so we ought to do what we can to prevent someone’s shortsighted cost savings decisions from making them lose their sight or their feet. We should make it as easy as possible for a poor diabetic to get to their doctors appointments, and not tempt them to switch.</p>
<p>CF, regarding your post 1547 – you are looking at an information sheet for a non-exchange plan. Note the paragraph under “Questions and Answers”:
</p>
<p>The exchanges are like the group policies described – coverage is extended to the “end of the year in which the adult child turns 26.” That’s how they are set up. </p>
<p>Just a note to everybody: The ACA is a LAW. The answers are either written in the actual law; or in the regulations promulgated by the agencies; or in opinions or memos issued by the agencies. There are some questions that are not answered yet because the law is unclear – but the point is, if one person says “the rule is X” and someone else says, “no, the rule is Y” – you have to listen to the person who can cite an authoriative source. An info sheet on an insurance company web site isn’t an authoritative source, except about that insurance company’s own practices (which theoretically could be in violation of law - insurance companies have been known to be wrong and to end up on the losing end of class action lawsuits because of their legal violations). My personal blog isn’t an authoritative source either, nor or my comments posted on this board – but I do try to provide links or references to authoritative sources when I have them.</p>
<p>I wondered about that. I haven’t tried out all the possible coverages, but you probably know the answer: Is the deductible/out-of-pocket also adjusted based upon income? For example, does the bronze plan for a subsidized enrollee have the same high deductible (like $5,000) as an unsubsidized enrollee? If so, how will these people pay for their care, aside from their premiums?</p>
<p>What about a middle class diabetic? My husband constantly skimps on his asthma medication because a refill is $350 dollars out of pocket. Now his insurance will likely go up again to fund the millions of “poor” people paying nothing. There are too many people in the wagon and not enough pulling it to make this work. Ever. And they must know that. The fine for opting out is next to nothing. The plans and deductibles are not affordable in out area. Why would a twenty-something sign up. Most are voluntarily uninsured now because they would rather risk it and spend that hundred bucks on pizza. I do not see how this can possibly work.</p>
<p>Most of the truly needy just think they are getting free health care. Like Obamaphones. They do not want deductibles, co-pays, and networks of a couple of doctors with likely long wait times for appointments. The website is appalling. I predict a train wreck.</p>
<p>If the lower-paid workers don’t like the charge for the employer policy, they can still buy on the exchange. If the cost of the policy for self-only coverage is more than 9.5% of their income, then they will be eligible for subsidies on the exchange (and I think the employer can be fined). But even if it is less than that, they are still eligible to buy coverage on the exchange without a subsidy – it’s quite possible that the younger workers will find that the exchange offers them a better deal.</p>
<p>I can buy on an exchange. I can buy a very, very similar policy off exchange for almost identical costs. Since one of my kids is turning 26 this year sounds like I should just buy on the exchange. Getting easier to buy on an exchange yet? :)</p>
<p>Somebody I grew up with was a diabetic. Dirt poor. Didnt buy insulin. Went into a diabetic coma. Died. Costs trying to help her after she fell into a coma. Over 1 million dollars. She was 59. </p>
<p>On a more positive note, a friend with a heart murmer
was paying 900 a month for health insurance. Just for him. Looks like he is going to be able to cover himself, his wife and his baby for 900 total. No subsidies. He is pretty excited.
He is 56 with a 33 year old wife and a baby. His energy level is thru the roof so I think a 33 year old wife is about right for him.</p>
<p>I don’t think the law specifies a limit, but I think that particular provision would require income verification, and the process can be effectively slowed down or limited by the specific procedures the exchanges use for such verification. </p>
<p>My guess is that the main intent of that provision is to allow people to make appropriate plan changes consistent with income changes. For example, someone who is on a subsidized cost-sharing Silver plan who experiences a disqualifying increase in income might want to drop down to a Bronze with lower premiums – someone who has been on a Bronze because they couldn’t afford higher premiums, would probably want to switch to Silver if they became eligible for the cost-sharing reduction. </p>
<p>If I were making the operational rules for an exchange, I’d tend to be pretty liberal allowing people to switch to different plans based on increased income – but insist on appropriate documentation from the people who are claiming to have become eligible for increased subsidies. It’s one thing if someone loses their job – quite another if someone is trying to game the system.</p>
<ol>
<li>The adult child is included in the calculation of household income.</li>
<li>If the adult child’s MAGI is also included, if the child earns enough to require paying taxes.</li>
</ol>
<p>Here is what I wrote about it somewhere else, which is a simple paraphrase of the statutory provision: </p>
Bronze, no. Silver, yes, if the person’s income is low enough that they are eligible for the separate cost-sharing reductions. Silver is the only tier level that allows for the cost-sharing reductions – so it is basically the level that most lower income individuals should be buying. </p>
<p>I think Bronze is most attractive to those at the ~400% level or above who are unsure about eligibility for premium assistance tax credits. </p>
<p>Those with incomes that are high enough that they are absolutely sure that they will not qualify for any tax credit may be better off to buy insurance products off the exchange – they may have more choice that way, and be able to find something that better fits their needs. All of the policies have to comply with the ACA mandates for essential benefit coverage and minimal actuarial value, but there’s a lot of flexibility for what can be in a policy above the bottom line.</p>
<p>Well, I for one am very excited that my 27 yr old with preexisting conditions and need for medication can get insurance at a reasonable rate. She works her butt off for an employer that does NOT offer insurance.</p>
<p>and calmom: THANK YOU FOR ALL YOUR HELP HERE!</p>
<p>That’s good! But it’s an easy fix that does not require the rest of this nonsense. ACA will hurt as many people as it will help IMHO. And no-one will ever understand it. We’ll see.
And while I understand parents desire to keep kids on their insurance I am not fully convinced that infantilizing adults is a great idea.</p>
<p>Bay, they do not have to be a financial dependent to be covered on your insurance. My 24 year old is covered. I haven’t claimed her on my tax return as a dependent for at least 4 years.</p>
<p>They can even be married filing jointly and still be covered on the parents’ insurance.</p>
<p>Generally when you see the word “and” in a sentence it means that what comes after is kind of important. </p>
<p>The law is that any adult child can obtain coverage on the exchange via his parents so long as he will not turn age 27 at any time during the taxable year for which coverage is sought.</p>