New Jersey parents soon may win guaranteed private health insurance coverage for their adult children with disabilities just as federal Medicaid cuts threaten access to highly specialized care.
Advocates hail pending legislation as a moral obligation and relief for families that fear losing hard-fought access to care providers. A lobbying group that represents health insurers, though, says it’s reviewing the proposed law for signs that it could raise costs.
At stake is insurance for special-needs adult children who age out of their parents’ health coverage at 26 years old. Right now, those adults can remain on commercial policies — which can cover very expensive specialized care — so long as a parent doesn’t leave the employer that pays for the bulk of coverage.
The bipartisan bill, which cleared the Assembly Financial Institutions and Insurance Committee last week, would require health insurers to maintain such benefits even if a parent changes jobs.
“It’s hard to argue that these kids and young adults don’t deserve continued care, and to the extent that the bill is trying to address that, I think it’s morally and ethically in the right place,” Frank Ghinassi, president and chief executive officer of Rutgers University Behavioral Health Care, told NJ Spotlight News.
The bill comes amid President Donald Trump’s threats to cut funding for Medicaid, including NJ FamilyCare, which has almost 2 million enrollees. Even when government funding is steady, it’s no simple matter to switch adult children with disabilities to Medicaid from private insurance. Specialists who are in employer-sponsored plans’ networks often don’t accept Medicaid, leaving patients stranded because out-of-pocket costs are so high.
“This bill would ensure that all of a sudden, at 26, I don’t have to go and look for a new care provider because suddenly they don’t accept my insurance anymore,” said Stacie Sherman, an Autism New Jersey spokeswoman who has two adult children on the autism spectrum. “It’s about continuing with the same doctors that you’ve searched so long for.”
The legislation could apply to more than 1 million residents, according to the New Jersey Association of Health Plans, a lobbying group that represents commercial and Medicaid insurance providers.
“While NJAHP is reviewing the bill to ensure that it would not unnecessarily raise costs for others covered by impacted plans, we believe the proposal aligns with our goal of broad access to affordable coverage by providing another option for parents and guardians of individuals with disabilities,” Wardell Sanders, the association’s president, said in a statement.
Both parties
The bill has support from both political parties. One sponsor, Assemblywoman Rosy Bagolie (D-Essex), said the bill would “close a dangerous gap in our law and would give families the stability and peace of mind they deserve.”
A Republican colleague, Assemblywoman Victoria Flynn from Monmouth County, said the legislation would relieve families of significant financial strain.
“It’s something that we really do need to address,” Flynn told NJ Spotlight News.
The legislation has been referred to the Assembly Oversight, Reform and Federal Relations Committee.
