Friday, 09 April 2010 00:00
Congressman Gary Ackerman’s almost full-page ad (See The Roslyn News, March 25, 2010 page 19) requires some comment. Rep. Ackerman asserts that starting this year “your children’s coverage can’t be denied because of pre-existing conditions.” This is just not true. The president got this wrong too. I guess they just didn’t read the bill.
How has the issue of a child with a pre-existing condition been handled in New York State? A child born to an insured mother is covered for the first thirty days of life under the mother’s plan no matter what condition the child may have. During these 30 days, the mother can add her child to her plan. Family health insurance plans cover all the children of the insured no matter what pre-existing condition one or more of the children have.
Child Health Plus covers children with pre-existing conditions. Child Health Plus is available at a reduced premium to children in families who are up to 400 percent of the Federal Poverty Level ($58,280 for a family of two). In addition, there are the New York State Physically Handicapped Children’s Programs. So how big a problem is denial of coverage and more importantly, denial of care for children with “pre-existing conditions” in New York State? If some children fall through the cracks, fix those situations locally. To suggest that the issue is a major problem in New York State is an insult to generations of New York State legislators, public health advocates and physicians.
And now for another misleading statement in Ackerman’s ad. Ackerman asserts that because of the recent signing of the health care insurance reform act, starting this year, children may remain on their parents’ health plan until they are 26 years old. Not so fast Gary. New York State passed a law in 2009 that allows eligible young adults to be covered under their parent’s group health insurance policy through age 29. I guess Gary doesn’t know this law either. What are the eligibility requirements for this law?
The young adult must:
Be unmarried; be 29 years of age or younger; not be insured by or eligible for comprehensive health insurance through his or her own employer; live, work or reside in New York State or the health insurance company’s service area and not be covered by Medicare.
The young adult does not have to live with a parent, be financially dependent on a parent, or be a student. The eligible young adult may have a child of his or her own. The grandchild is not covered by the grandparent’s plan. The grandchild may be covered by Child Health Plus or Medicaid or maybe neither because the parent with whom the child lives makes too much money.
The eligibility requirements for the young adult benefit under Obamacare may be different, but at least we know the eligibility requirements under the New York State law. Does anybody know the eligibility requirements under Obamacare? If anybody does know, they’re not telling us. How typical of the new federal law.
The most serious problem with Congressman Ackerman’s ad is he is telling you what you are going to get, but not what they’re gonna take.
Melvin Hollander, M.D.