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Military Families Left Out of Expanded Health Coverage for Adult Children

By Jane Norman, CQ HealthBeat Associate Editor

September 27, 2010 -- A section of the health care law that went into effect Sept. 23 expanded coverage for young adults under their parents' policies, but military families weren't included—and it's not clear how soon they will be able to take advantage of the popular provision.

The health care law (PL 11-148, PL 111-152) doesn't affect Tricare, the health insurance program for members of the military and their dependents, because Tricare was specifically excluded. But members of the military objected, saying they want to be allowed to include their children up to age 26 under their health insurance policies.

Lawmakers then moved to insert a provision for young-adult coverage in the 2011 defense authorization bill (S 3454), but that bill stalled in the Senate earlier this month. Republicans united to block it after Majority Leader Harry Reid rejected their offer to limit initial debate to strictly defense-related amendments. While chances of action prior to the November election appear slim, it could conceivably be passed during a lame-duck session.

Tricare now covers dependent children up to the age of 21, or 23 if they are enrolled at an accredited educational institution and rely on a parent for more than 50 percent of their financial support.

Sen. Mark Udall, D-Colo., who introduced a stand-alone bill to provide young-adult coverage under Tricare, said he is still trying to get something done. Service members around the world worry about the health and financial security of their families back home, and they deserve the same "peace of mind" as the civilian population, he said.

This is one of the many provisions in the defense authorization bill that directly impacts military families, and it's one of the many reasons why we need to pass the legislation this year," Udall said in a statement to CQ HealthBeat. "And if not, I will be looking for another way to pass it, either as part of another piece of legislation or as a stand-alone bill."

Lobbyists say there is a possibility of a bill that would provide interim coverage until the defense authorization bill is approved.

Also still left unresolved is whether coverage could be expanded as well for the adult children of military veterans under the separate Civilian Health and Medical Program of the Veterans Affairs Department. Sen. Daniel Akaka, D-Hawaii, on Sept. 16 introduced stand-alone legislation (S 3801) to do that, saying it's "only fair" to give them the same benefits as civilian families.

Capt. Marshall Hanson, legislative director for the private Reserve Officers Association, said that the Department of Defense has plans for the expanded coverage in the works but can't move ahead without congressional action. "Many beneficiaries are asking about this, because of how the economy is impacting employment and resulting benefits for their children," he said.

Hanson added that it's also uncertain, without action from Congress, whether the government can charge special premiums for those newly covered dependents. Active duty members of the service and retirees under the basic entitlement in general pay low or no annual or monthly fees, unlike private insurance. Active duty service members do not pay anything for medical care.

If the premiums for dependent care are not charged, "this will add to DOD's argument to next year's Congress to increase fees charged to military retirees, and perhaps military families to offset the additional costs," Hanson said.

Barbara Cohoon, deputy director for government relations for the National Military Families Association, said that interest among military families remains high, especially those with children nearing the age 23 cutoff.

"Our families do want this particular coverage and have been asking for it," said Cohoon.

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