No more private health insurance for children?

September 11, 2010 2:56 PM

I want to do the responsible thing and buy my children health insurance when our COBRA policy expires this month. I am being told that this is simply not possible due to the "unforeseen consequences" of healthcare reform going into effect 9/23/2010. Surely I'm missing something. Can someone explain what's going on and what I can do before they go uninsured 10/1?

Ehealthinsurance.com said that because of legislative changes, health insurance companies have decided to stop selling policies for children with an effective date after 9/23/2010. No one will sell me a policy despite the fact they are perfectly healthy and I am willing to pay whatever it takes. WTH?
Our COBRA policy is expiring, (we) parents cannot qualify for private insurance due to high-risk conditions.

posted by anonymous to work & money (9 answers total)

I'd reccomend emailing a mod about what state you live in. Your children may qualify for SCHIP, depending on state.

healthcare.gov has more info about health care providers in your area.
posted by ALongDecember at 3:14 PM on September 11, 2010

Call your state's insurance commissioner's office Monday morning and ask them what the actual law is and how you can get your kids insured.
posted by fairytale of los angeles at 3:16 PM on September 11, 2010 [3 favorites]

What's going on is that for plan years beginning 9/23/10 (6 months after enactment) or later, the healthcare reform law prohibits insurers from imposing pre-existing condition exclusions/limitations on children age 19 or younger.

Here's a report (pdf) from the Congressional Research Service summarizing "Preexisting Exclusion Provisions for Children and Dependent Coverage under the Patient Protection and Affordable Care Act (PPACA)."

As ALongDecember suggested, check the information for your state available at Healthcare.gov, the new national self-service tool for people seeking health insurance.
posted by Snerd at 3:46 PM on September 11, 2010

Health insurance is one of the few areas where a broker can be useful. A local agency (look for one that calls itself an "independent insurance agency" vs one that is affiliated with a specific company, like State Farm) will likely be able to help you locate a plan that meets your needs at the lowest possible cost.

And, yeah, the insurance commissioner's office for your state. I'm not sure what "ehealthinsurance.com" is, but I suspect they're not fully versed in what's available in your state. Its very, very likely if you had a COBRA plan that your kids qualify for whatever SCHIP is in your state.
posted by anastasiav at 3:54 PM on September 11, 2010 [2 favorites]

If you can't get anything through the state's insurance commissioner, I would contact your reps in your state legislature and let them know about your problem.
posted by elpea at 4:51 PM on September 11, 2010

My wife says to Google "open enrollment healthcare children". She works in underwriting and cannot confirm or deny that some legislation may be passed on 9/22 that will fix this, and if not, the private insurance companies may relax this policy themselves or be forced to offer a period of open enrollment. She also says all the above answers are very helpful.
posted by PSB at 6:19 PM on September 11, 2010 [2 favorites]

Seconding finding an indepent insurance agent/broker. Memail me if you're in Oregon because I can recommend my agent.
posted by vespabelle at 7:29 PM on September 11, 2010

Note that the OP said he/she and the co-parent have preexes, not the kinds.

If your children are exhausting COBRA (and a few other qualifications, such as having a group health plan for 18 months before that), your children may still be eligible for a HIPAA qualifying individual policy. Call your state department of insurance and ask about HIPAA individual policies. MeMail me if you don't know how to contact your state DOI.

CHIP (it's called CHIP not SCHIP these days) may be an option, but it usually depends on your income. Your state location is important because your options vary dramatically depending on what your state has done with CHIP and/or Medicaid expansion.
posted by Pax at 4:07 PM on September 12, 2010

(not the kids).
posted by Pax at 4:11 PM on September 12, 2010