By Jessica Lowy
Stuttgart Law Center
Q: How does the Affordable Care Act affect military families?
A: The Patient Protection and Affordable Care Act, more commonly referred to as “Obamacare” or the ACA, marked a dramatic expansion of health care in the United States. The president signed the bill into law on March 23, 2010, and the Supreme Court largely upheld it on June 28, 2012.
Although the ACA is lengthy and complicated, you should be aware of a few key points it includes: 1) a mandate requiring almost all uninsured individuals to purchase an approved private health insurance policy or pay a tax penalty for not purchasing a coverage plan; 2) a prohibition on insurance companies’ ability to deny coverage based on pre-existing conditions or gender; 3) a requirement that insurance companies cover certain preventative procedures at no cost; and 4) insurers offering dependent coverage must also allow dependent children to be covered on their parents’ insurance policy up to age 26.
Though these provisions will have an immense effect on people already insured, or looking to be insured, by private sector health insurance plans, the effect on most military families is minimal. Primarily, because any service member and qualifying dependents have the ability to enroll in Tricare, regardless of any pre-existing medical condition, the imposition of an individual mandate is moot. Additionally, Tricare already provides most screening, testing, and preventative health care procedures to beneficiaries at little or no cost.
There is good news for military families with adult dependents. Previously, military dependents could remain on regular Tricare until age 21 or 23 if he or she was a full-time college student. Tricare established Tricare Young Adult in 2011 to provide military dependents with the same extension of coverage required by the ACA. In May 2013, the Obama administration made TYA permanent. Eligible sponsors can purchase TYA for their qualified adult dependents after eligibility for regular Tricare ends at age 21 or if enrolled in college, 23. TYA is available to all unmarried children of Tricare eligible sponsors under the age of 26 who are not immediately eligible for their own employer-sponsored health insurance. However, the sponsor must be either active duty, retired, or in certain categories of guard or reservists. There are also certain premiums and fees, depending on the sponsor’s status.
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This column is not intended as individual or specific legal advice. If you have specific issues or concerns, you should consult a judge advocate at 421-4152/civ. 0711-729-4152.