Some Recent Grads Face Health Care Coverage Gap Despite a health care overhaul provision that allows young adults to stay on their parents' health plans until age 26, many 20-somethings and their families are discovering that when that coverage begins varies. It creates what the new health care legislation was supposed to eradicate: health care haves and have-nots.
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Some Recent Grads Face Health Care Coverage Gap

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Some Recent Grads Face Health Care Coverage Gap

Some Recent Grads Face Health Care Coverage Gap

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One of the early benefits of the country's new health law is letting young adults stay on their parents' health plans. But as with everything related to health care, the reality turns out to be a little more complicated than that simple description. NPR's Julie Rovner brings us the rest of the story.

JULIE ROVNER: Robin Byrne is one of the lucky ones. For her the new law is working exactly as its authors envisioned. The 22-year-old just graduated from Gettysburg College in Pennsylvania with a degree in economics and international affairs. She's off to do a Fulbright fellowship this fall, studying in Muscat, Oman. But between now and then she'll need health insurance.

Ms. ROBIN BYRNE: I have asthma. I mean, very mild, but it does mean I have to buy inhalers. And they're not terribly expensive, but out of pocket they would certainly be more expensive than with our prescription coverage.

ROVNER: The good news is that her mother's health plan, which comes from a local government job in New Jersey, is going to continue to cover her both before and after her fellowship. Byrne says the security of knowing she'd be able to stay on her mom's plan gave her more freedom to pursue her career goals.

Ms. BYRNE: Knowing that I would be covered, I felt a little bit more comfortable applying to, not necessarily riskier programs, but programs that may or may not have extended health insurance, rather than just looking for traditional employment.

ROVNER: But things haven't gone quite so smoothly for everyone finishing college this spring. Jackson Cahn graduated this weekend from Whitman College in Walla Walla, Washington. The biochemistry and biophysics major is taking a year off to teach before pursuing graduate studies.

His mom, June Blender, said she was delighted when the provision letting young adults stay on their parents' health plans remained in the bill that was signed into law. But then she was disappointed when she learned that it doesn't take effect right away and that her employer, Microsoft, wasn't going to make it available to Jackson until the next open season for benefits this fall.

Ms. JUNE BLENDER (Employee, Microsoft): The open season begins in November. But he graduates on the 23rd of May, so there's a significant gap in his insurance.

ROVNER: And because Jackson, like Robin Byrne, has asthma, buying even temporary insurance on the open market probably isn't an option.

Ms. BLENDER: He definitely needs health insurance and we can't afford a seven month-or-something gap.

ROVNER: But this story has a happy ending too. It turns out that Jackson can qualify for his stepfather's insurance, starting in June, until he can get back on his mom's plan next January.

Still, what looks like a fairly simple element of the new health law - letting young adults stay on their parents' health plans - turns out to be anything but. One of the reasons the whole thing has gotten so confusing is that the decision about when to start the new benefit is being made by lots of different players in the health system.

For example, many health insurance companies have decided to begin offering the coverage to graduating college students in June. That's earlier than the law requires. But for most people with insurance at work, it's not the insurance company that decides what their benefits are - it's the employer.

Paul Dennett is a senior vice president for health care at the American Benefits Council, a trade group for large employers.

Mr. PAUL DENNETT (American Benefits Council): For all of the Americans that have coverage through an employer - and that's about 160 million Americans -roughly two-thirds of that number are with a self-insured employer.

ROVNER: That means the decision about when to start the benefit is made by the employer.

According to the new law, health plans are required to start offering coverage to young adults who are no longer students starting on the first policy renewal date after September 23rd. For many plans that will mean January 1st of next year. That will leave a multi-month gap for a lot of graduating college seniors.

But Dennett says employers that decide to wait may be concerned about the requirement that they offer coverage to every young adult up to age 26, not just this year's graduating class.

Mr. DENNETT: The law will also apply to individuals who aren't on the plan right now, because they graduated a year or two ago, and lost coverage under their family's plan - or maybe never elected it at all - who will have that new opportunity to do so.

ROVNER: Thus, he says, it may be simpler for the company and more fair to let all young adults sign up at once. But once again, that's going to lead - at least in the short run - to some health care haves and have-nots.

Julie Rovner, NPR News, Washington.

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