The Obama Administration and supporters of the Affordable Care Act never fail to tout one of the innovations in the law that has already come into practice. That’s the allowance of children to stay on their parents’ insurance up to age 26, which has allowed by one estimate over 2 million sons and daughters to maintain their insurance coverage. With youth unemployment at a high and more and more entry-level positions coming with no insurance plan, this has allowed a smoother transition into adulthood for millions of people.
However, if those same under-26 plan beneficiaries want to have a child, they may have to look elsewhere for coverage.
Group health plans with 15 or more workers are required to provide maternity benefits for employees and their spouses under the Pregnancy Discrimination Act of 1978. But other dependents of employees aren’t covered by the law, so companies don’t have to provide maternity coverage for them.
Although hard numbers aren’t available on how many companies don’t provide dependent maternity benefits, “I would say it’s common,” says Dania Palanker, a senior health policy adviser at the National Women’s Law Center. And the number could grow with the recent expansion of coverage to children under age 26, she says.
Dan Priga, who heads the performance audit group for Mercer, a human resources consulting company, estimates that roughly 70 percent of companies that pay their employees’ health-care claims directly choose not to provide dependent maternity benefits.
This is a quirk in the law that had almost no effect when the cutoff date was 18, that now becomes a problem when that gets expanded to 26. I would think it will be difficult to get employers to suddenly open up maternity coverage to dependents, which is a pure cost outlay with little in the way of benefits. Either this causes premiums to rise considerably for those who elect maternity coverage, or a substantial number of young women on their parents’ plans are out of luck should they find themselves pregnant. Perhaps the young women, if they have no visible means of support, could get on Medicaid, if they’re lucky enough to find a doctor to accept it. Some employers may be forced to take up maternity and pre-natal care as part of the preventive services mandate, but only on new plans, and not at all for large-group employers or self-insured plans. Oh well, fortunately young women don’t have a lot of children or anything.
All of these little quirks and unintended consequences spring from the fact that we do not have a coherent health care system in the United States. Instead, we have a series of overlapping systems that often conflict or contradict with one another. The obvious solution to this is to create a system where everyone is covered under one standard, eliminating the proliferation of these Easter egg surprises from cropping up.