This week the Centers for Medicare & Medicaid Services (CMS) announced several new strategies to boost enrollment of the coveted “young invincibles” in health insurance marketplaces. These primarily include more targeted outreach and messaging, particularly to those who had to pay the tax penalty for failing to maintain health insurance (disproportionately young adults) and those turning 26 and transitioning off their parents’ plan.
These are all smart strategies, but the administration has not yet fixed an enrollment glitch that particularly affects young adults – and could hinder some from getting covered. We wrote about this in our recent report documenting calls made to the federally facilitated marketplace’s (FFM) call center for navigators and consumer assisters.
Consumer assisters receive frequent questions from parents who want their son or daughter to enroll in their family plan. The Affordable Care Act includes a requirement that health plans permit children under age 26 to stay on their parents’ health plan, regardless of whether or not the child is a tax dependent. However, the FFM currently requires adults under age 26 who are not tax dependents to be assessed separately for subsidy eligibility. The FFM platform does not allow them to enroll together under a family plan if they want to receive subsidies.
This can have significant financial implications. For example, a young adult whose eligibility for subsidies is screened separately from his or her parents may not have sufficient income to meet the income threshold for premium tax credits (100 percent of the federal poverty line). In a state that hasn’t expanded Medicaid, this may mean that the young person falls into the coverage gap. In addition, a young adult child enrolling separately into a QHP must pay a separate premium and meet a separate deductible and out-of-pocket maximum from the rest of his or her family.
To fix this, the FFM should allow young people under 26 not claimed as a tax dependent by their parents to be screened for tax credit eligibility along with their parents. This would not only help more young people get covered, but would also allow young people to stay on their parents’ plan until they turn 26, as the law intended.