Health insurance: Coverage expands for children, young adults; not necessarily for retirees

News outlets covered a number of health insurance issues this weekend.

The Wall Street Journal: "Glenn Franco, a retired community-college instructor in Michigan, tried to get his 24-year-old daughter on his health plan—and was turned away.  ... Many large employers are telling retirees the same thing. They include Alcatel-Lucent and Verizon Communications Inc., as well as state and federal government plans and those for military families and unions. Thanks to a little-noticed clause in a 1996 law, retiree-only health plans are exempt from the Patient Protection and Affordable Care Act that went into effect last month."

"A retiree health plan is one that provides coverage until age 65, after which it either phases out or acts as a supplement to Medicare. ... Employers say they might drop retiree coverage altogether if Congress were to force them to extend dependent coverage and comply with other provisions under HIPAA and the ACA" (Schultz and Silver-Greenberg, 10/9).

KCAU-TV (Sioux City, Iowa): "The National Retirees Legislative Network says retirees insured under employee provided plans are exempt from seven of the law's reforms. ... The NRLN says the provision disallowing lifetime, or annual limits from the insurance companies won't apply to retirees. And the organization says the change prohibiting denial of coverage based on preexisting conditions will also leave out retirees" (10/9).

The Wall Street Journal, in a separate story: "Under the new law, most big employers will make adult-child health-insurance coverage available for workers starting in the open-enrollment period this fall for the plan year beginning in January 2011, though some may permit enrollment sooner. ... If there's a gap before you can sign up an adult child for coverage, look for a short-term insurance plan or other health plan, including public plans for low-income adults and families. ... Check for exclusions, co-pays and deductibles if you opt for an individual plan. Also, check whether an employer-provided or individual plan covers your child in another state" (McQueen, 10/10).

Modern Healthcare: "When the healthcare reform law's provisions kick in more fully in 2014, up to 81% of the 14.9 million adults ages 19 to 29 who were uninsured in 2009 could be expected to have gained coverage, according to a new report from the Commonwealth Fund. The 12.1 million who are expected to gain coverage include 7.2 million who would be covered by expanded Medicaid programs and 4.9 million who would gain subsidized private insurance coverage, according to the report. The law will not reach 1.8 million undocumented people in that age group; undocumented individuals are not eligible for Medicaid or the subsidized insurance plans through health insurance exchanges, according to the report" (Galloro, 10/10).

MedPage Today: "More than 12 million of the nation's 15 million uninsured young adults ages 19 to 29 may be able to get health insurance in 2014 as a result of the healthcare reform law, according to a report released Friday by the Commonwealth Fund.  ... The number of uninsured young adults rose from 13.7 million in 2008 to 14.8 million in 2009. In addition, 5 million insured 20somethings have very high out-of-pocket costs, leaving them effectively underinsured, the authors noted. Citing the Commonwealth Fund Survey of Young Adults, Collins and Nicholson noted two key points at which young adults lose coverage: when they turn 19 -- ageing out of dependent coverage as a high school student or under Medicaid or the Children's Health Insurance Program (CHIP) -- and when they graduate from college" (Frieden, 10/8).

Medical News Today: "Less than 1 in every 3 people in the USA aged between 19 and 29 currently has health coverage. This new legislation aims to address this. The uninsured rate among employed young adults is about 33% higher than older employed adults. ... According to the US Department of Health and Human Services, saying that young people do not need health insurance is a myth. Approximately 1 in every 6 young adults in the USA has a chronic illness, such as asthma, diabetes or cancer. Almost half of all young American adults say they have difficulties paying their medical bills (Nordqvist, 10/10).

The New York Times: "Government health insurance for children is no longer available only for the poorest households. Now middle-class families ... can benefit as well. The Census Bureau recently reported that the poverty rate was up, and the number of insured adults was down. But the news was brighter for children. The percentage of children under age 19 with insurance edged up to 91 percent last year, a record high, from 90.3 percent in 2008. ... Children in families with incomes of up to $44,100 (for a family of four) are likely to be eligible for some kind of government health insurance. In states where the cost of living is high, the income limits are even greater. In New York State, the cutoff for a family of four is $88,200; in New Jersey, it is $77,175" (Alderman, 10/8).

Crain's New York Business: "Rosina Rubin wants answers about health care. As chief financial officer of chauffeur service Attitude New York, she wants to know why her health care provider, GHI, is asking state regulators for permission to hike insurance premiums by 50% to 74%. The Manhattan-based business, with about $5 million in revenue, already switched carriers after its 2010 health insurance bill increased nearly 40%. ... Ms. Rubin is not the only one with questions. Insurers will increase their 2011 rates in New York City by the highest percentage in seven years, according to data from Aon Hewitt, a human resources consulting firm. The projected 8.7% average hike will fall disproportionately on the self-employed and on small businesses like Ms. Rubin's" (Chappatta, 10/10).