Will Child-Only Georgia Health Insurance Plans Be Restored?

By: JohnBarnes

When the 2010 Patient Protection and Affordable Care Act became law, it changed the way health care was provided for millions of Americans. The health care reform law made several changes in the health insurance industry, but not all of them were intended.

One of the unintended changes in the insurance market involved child-only health care policies. In Georgia and other states, as the Affordable Care Act took hold, insurance companies stopped offering this type of healthcare plan.

Child-only Georgia health insurance plans are usually bought by parents who have an employer-provided health plan that does not include dependent coverage, or has dependent coverage they just can’t afford. Sometimes these plans are bought by parents who can’t get health coverage for themselves due to health reasons and still want to provide coverage for their children. And sometimes, these are bought by parents whose income does not qualify for their kids to get coverage under Medicaid or PeachCare.

How Did The Affordable Care Act Affect Child-Only Policies?

One of the mandates of the act is that no children with pre-existing conditions can be denied health coverage. In response to this mandate, insurance companies in various states, including Georgia, stopped offering new individual plans that only cover children.

According to the insurance industry, under this new requirement, parents could postpone getting health care coverage for their children until the kids were sick. The industry said that this would cause a rise in unprofitable health care plans and skyrocketing expenses for the insurance companies to budget.

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Will Child-Only Georgia Health Insurance Plans Return?

An increasing number of states have made a move to address the loss of availability of child-only health care policies, either through legislation or regulation.

In Georgia, House Bill 1166 was presented to address this problem. HB 1166 plans to restore these child-only health policies that can be offered by the private Georgia health insurance market.

Legislation recently passed the House Insurance Committee that would require Georgia health insurance companies that sell individual health coverage to also offer child-only health care plans during an open enrollment period. The bill would permit insurance companies to impose a surcharge of 50 percent of the premium if a child has been without health coverage for more than 63 days prior to the application for coverage. By doing so, this will motivate parents to keep their children insured and not wait for their child to get sick before getting a Georgia health insurance plan.

According to Graham Thompson, executive director of the Georgia Association of Health Plans, the healthcare insurance industry has signed off on the legislation.

It was Cindy Zeldin, executive director of Georgians for a Healthy Future, who pushed for the bill. She said that fixing up this unintended consequence of reform is relatively easy. This will help kids get the Georgia health insurance coverage they need since having health coverage is very important. Hospital admission records from 37 different states all showed the dire consequences of not covering children with health insurance. Regardless of the hospital where they were admitted, children without health insurance died 60 percent more often than kids who were covered. The reason for admitting them to the hospital did not alter the outcome, either. Children without health care, like adults, died more often even in the hospital. Zeldin also added, “It’s unfair that some parents are willing to pay for healthcare coverage for their kids, and it’s not available.”

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The bill just covers one year (2013) since the problem will be taken care of by 2014 when federal health care reform will be totally implemented. By then, the new state-based Georgia health insurance market should be up and running with new Georgia health coverage options.