On Wednesday, Sen. Jim Wilson filed legislation to ensure access to individual health insurance for Oklahoma children. The Tahlequah Democrat said his bill is in response to the new rule allowing insurance companies writing policies in Oklahoma to avoid the Affordable Care Act requirement to offer health insurance for all children without regard to the child’s health status or condition. Senate Bill 1181 requires all insurance carriers selling individual health benefit plans in Oklahoma to provide at least one child only health benefit plan, which is one where there is no adult on the individual policy.
“As a government, we have a moral obligation to protect the health of our most vulnerable citizens, our children,” said Wilson. “As many of us know all too well life can be uncertain. We never know what could happen tomorrow, but parents and guardians need the ability to look out for the wellbeing of those in their care.”
Wilson explained there are many scenarios where families need access to child-only health policies – the parents may be insured through an employer-sponsored plan which doesn’t offer dependent coverage or the family may not be able to afford coverage for all their members and is seeking coverage for the children only.
A very common situation in Oklahoma is retired grandparents having custody of their grandchildren and they are on Medicare and make too much to qualify for Medicaid for the child. Life events such as divorce or job loss may also affect insurance coverage.
Under SB 1181, the first open enrollment period would begin on the first of the month closest to ninety days after the effective date of the Act. In subsequent years, the open enrollment periods would be in January and July. Coverage obtained during those months would become effective 30 days after the end of the open enrollment period.
Outside of a qualifying event, a child-only policy could be applied for only during an open enrollment period. The policies provide coverage for individuals under the age of nineteen. Wilson explained that children who lose coverage due to a qualifying event could obtain child-only coverage by applying within thirty days of that event. Qualifying events include birth, adoption, marriage, dissolution of marriage, loss of employer-sponsored coverage, loss of Medicaid or Children’s Basic Health Plan coverage, entry of a court or administrative order mandating coverage, etc.
SB 1181 is patterned after Colorado’s law, which was approved in 2011. Other states such as California (2010) and Arkansas (2011) have also passed laws requiring all insurers doing business in their states to offer child-only policies. Kentucky did not pass a law on the issue, but it’s Insurance Commissioner issued an order requiring insurance companies to offer child-only policies during a specified enrollment period each year.