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POLICY INSIGHT
BEYOND THE NUMBERS

Health Reform Gives Young Adults Coverage Choices

Health reform has already benefitted adults under age 26 by allowing them to obtain health insurance coverage under their parents’ policies — a feature of the law that is providing coverage to more than 3 million young adults.  Millions more will gain access to coverage in 2014, when new, federally financed premium subsidies will help reduce what low- and moderate-income people will have to pay for coverage.

But Rep. Paul Ryan (R-WI) gave a false impression of how those coverage options will work at a House Ways and Means Committee hearing last week.  He incorrectly claimed that under health reform, young adults under age 26 who earn between 100 and 400 percent of the federal poverty line will be ineligible for federal tax credits to help pay their premiums for plans offered through the new health insurance marketplaces (also known as exchanges) if they can get coverage under their parents’ plan.

That’s simply not true.  Most young adults will have multiple coverage options.  They can obtain coverage through their parents’ plan if available, or through their own employer if their job offers health coverage.  Young adults may also qualify for Medicaid depending on their income and on whether their state has chosen to adopt health reform’s Medicaid expansion to cover low-income adults.

For young adults who are not eligible for Medicaid, premium tax credits would be an option as well, as long as they have incomes in the subsidy-eligibility range (100 percent to 400 percent of the poverty line), their parents don’t claim them as a dependent on their tax return, and they don’t have an offer of affordable and adequate coverage from their own employer.  The fact that they also can enroll under their parents’ policy does not in and of itself preclude them from obtaining exchange coverage using the premium credits.

Young adults will have to choose their coverage options carefully, considering each available option’s costs, benefits, and provider networks, for example.  But the result will be a welcome one:  more young people will have greater access to much-needed health insurance coverage.