One of the most anticipated parts of the new federal health care law is a provision allowing parents to keep adult children on their health insurance plans up to age 26.
In Florida, where as many as a third of the state's 19- to 24-year-olds are uninsured, the impact should be significant, especially since this population has seen some of the biggest increases among adults going without health coverage.
The law appears to apply broadly to adult children whose parents want to extend their own insurance coverage and can include children who are out of school and living on their own. Experts say it is intended to help young adults including those who are employed but are in jobs where health insurance isn't offered.
While details on the degree to which they can be financially independent remain to be clarified in the coming weeks, experts say this much is clear: Many parents and their adult children are going to be able to sleep easier.
"A lot of the students coming out with liberal arts degrees are being forced into graduate programs because being in school means that you can continue to be on your parent's insurance," said 22-year-old Ryan Brennan. He will graduate from the University of South Florida this spring with a degree in Africana studies and is applying to law school.
"If they enter the job market and find they can't get anything, or if they decide to wait to go back and get an upper-level degree after a few years, they have that time when they will be covered."
• • •
Despite stereotypes about "young invincibles" choosing to go without health coverage because they can't imagine getting sick, experts say young adults tend to be uninsured for the same reasons as older workers: They don't make enough to afford insurance, or their employers don't offer and subsidize it as a benefit.
And as they are new to the labor force, this age group is especially likely to hold part-time and entry-level jobs or work for small businesses. Many have struggled to find jobs in a dismal economy.
"A lot of people love this image of some rich, young Wall Street MBA who's 24 years old and driving his BMW and doesn't want to buy health insurance," said Paul Duncan, a professor of health services research at the University of Florida's College of Public Health. But in fact, "it's a great myth."
In a statewide survey, Duncan found that more than a third of Florida's 19- to 24-year-olds lacked insurance in 2004. And this age group saw the biggest increase in adults without health insurance over the prior five years.
The situation can be dire for children with chronic diseases who increasingly live into adulthood. These include young cancer survivors, children with congenital heart disease and those with cystic fibrosis.
They can struggle to have their ongoing health needs met after aging out of their parents' insurance plans and government safety-net programs just for children.
"There's no question some of them are falling out of the system," said Dr. Michael Epstein, a pediatric cardiologist and senior vice president for medical affairs at All Children's Hospital in St. Petersburg.
"It's a problem we have even with patients that don't have chronic health care needs. They can't find a provider, then they end up using an ER when they get sick."
• • •
In recent years, Florida has tried to boost coverage for young adults, whose coverage options now vary considerably from state to state.
Currently, Florida requires policies with dependent coverage to insure adult children until age 25 if they depend on their parents for support. In such cases, the child must live at home, or be a student.
Two years ago, the state attempted to go further, passing a new law that expanded dependent coverage to 25- to 30-year-olds who were unmarried (and without children of their own). To qualify, these young adults also must be Florida residents or students and without other health insurance.
Not all policies offer dependent coverage, however, so these rules don't apply universally. And self-funded plans are exempt, including those at large employers like Disney and Publix, said Mary Beth Senkewicz, the Florida Office of Insurance Regulation's deputy insurance commissioner for life and health.
Industry experts say the new state law hasn't gotten much attention and questions remain over how it is supposed to be applied. It's not thought to be a widely used benefit.
"It's certainly hard to think that something is a protection out there for you, if people aren't aware of the extent to which it's applicable to you and it's being used," said Greg Mellowe, policy director for the Florida Community Health Action Information Network, or CHAIN, an advocacy group for affordable health care.
• • •
The new federal law appears to be more straightforward. In six months, health plans would be required to allow young adults to remain on their parents' health policies until age 26, with their parents' agreement. This would apply to almost all existing plans. But it's only for adult children who aren't offered coverage through their employers, and grandchildren aren't eligible.
Florida's Office of Insurance Regulation declined to address the impact of the federal legislation on existing state law. It noted in a statement that it will be cooperating with Attorney General Bill McCollum's lawsuit seeking to declare the health reform law unconstitutional.
Experts say states generally can keep health care protections considered more consumer friendly than the federal requirements.
Letitia Stein can be reached at [email protected] or (813) 226-3322. For more health news, visit tampabay.com/health.