An Affordable Care Act provision will extend access to dependent health coverage to children up to age 26, but the provision does not define the word “child.”
Many of the members of the public who submitted the 81 comments reacting to federal agencies’ interim final rule implementing the young-adult coverage access provision have suggested definitions that, at the very least, would include adopted children and stepchildren.
The effort to define “child” is just one small part of those comments,
|A journey of 1,000 regulations must start with many discussions about terminology.|
and the dependent coverage provision is just one of many major provisions in the Affordable Care Act – the legislative package that includes the Patient Protection and Affordable Care Act (PPACA) – that will take effect for health plan or health insurance plan years starting on or after today.
President Obama signed the bill that created PPACA March 23.
Some of the other provisions coming online today include the new restrictions on policy rescissions, a ban on using information about pre-existing conditions when deciding whether to sell coverage to a child, new restrictions on annual health benefits maximums, and a provision requiring non-grandfathered plans to provide coverage for designated preventive care services, such as mammograms, without applying deductible requirements or other cost-sharing requirements.
The Employee Benefits Security Administration (EBSA), an arm of the U.S. Labor Department, is working with the Internal Revenue Service and the Office of Consumer Information and
Insurance Oversight (OCIIO), a new division of the U.S. Department of Health and Human Services, to implement the Affordable Care Act provisions.
The agencies say they are using interim final regulations, rather than regulations that have gone through the full public comment process, to implement the PPACA provisions that are starting to take effect today because of the tight deadlines Congress imposed when it drafted the act. Use of interim final regulation process means that agencies start by posting regulations, and then collect and analyze public comments after the regulations are posted.
In the comments on the dependent coverage access provision, Mary Burns, an official with the New York State Insurance Department, took note of the lack of definition of the word “child.”
“We are aware that some insurers are interpreting this silence to mean that only biological children must be covered and that insurers and policyholders may cover adopted children and stepchildren at their option, unless state law addresses the issue,” Burns says. “We would suggest that the regulation define ‘child’ to include adopted and stepchildren, as it does not appear that the intent of the law was to exclude these children.”