States in Action Archive

States in Action: Innovations in State Health Policy, is a former publication of the State Health Policy and Practices program. This bimonthly newsletter tracked innovative strategies certain states used to stretch health care dollars and improve the quality of care.

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Illinois Joining Other States in Extending Age for Dependent Coverage

Beginning January 1, 2009, Illinois parents will be able to keep their unmarried children on their health insurance plans until they reach age 26, or age 30 if they are military veterans. This could allow up to 300,000 young adults to stay on their parents' insurance plans. This provision is part of Governor Rod Blagojevich's "Rewrite to Do Right" campaign, in which he used amendatory veto power to revise a prior proposal that had a more modest dependent coverage extension.[1]

About 30 percent of Americans ages 19 through 29—13.7 million individuals in 2006—do not have health coverage.[2] No longer considered dependents, they often lose coverage at age 19 or upon high school or college graduation. In fact, 38 percent of high school graduates who do not attend college and one-third of college graduates are uninsured for some period of time during the year after graduation.[3]

Illinois is among a growing cadre of states trying to reduce the number of uninsured young adults by extending the time they can remain on their parents' insurance policies. Twenty-four states have moved from allowing insurers to set their own dependent age limits to defining dependent to include older children.[4] Most commonly, these states have extended the dependent age limit to "up to" age 24, 25, or 26. All states require the dependent to be unmarried. Some states set two age limits; for example, Idaho defines dependent as up to age 21 if unmarried, and from ages 21 to 25 if unmarried, a full-time student, and financially dependent on parents. New Jersey has set the highest age limit: young adults can retain coverage as dependents through age 30 if they are unmarried, uninsured, have none of their own dependents, and are either a resident of the state or a full-time student. To protect against the potential for young adults to wait to join their parents' plan until they need health services, New Jersey requires that young adults apply to continue coverage within 30 days from when they would have previously aged off of a policy, or during an open enrollment period.

While some insurers and business representatives fear that premiums may rise quickly when very sick young people remain on their parents' plans, supporters view these coverage expansions as a positive trend that promotes access to care and adds greater numbers of young, healthy individuals to the insurance pool. It is also a way for states to expand coverage without making public expenditures.

For More Information
See: J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May 2008.
National Conference of State Legislatures
Kaiser Family Commission State Health Facts

References
[1] Under a previous version of Illinois House Bill 5285, insurers would have been required to continue offering coverage for one year to dependent, full-time college students who leave school or reduce school participation due to catastrophic illness or injury.
[2] National Conference of State Legislatures, www.ncsl.org/programs/health/dependentstatus.htm.
[3] J. L. Kriss, S. R. Collins, B. Mahato, E. Gould, and C. Schoen, Why Young Adults Become Uninsured and How New Policies Can Help, 2008 Update, The Commonwealth Fund, May 2008.
[4] Insurers commonly set limits at age 18 or 19, extended to 21 or 22 if child is a full-time student.
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