Father of autistic son takes advantage of health care law

FREMONT, Calif. — Dr. Albert Wang thanks his lucky stars every day that he is able to provide his 23-year-old autistic son with health insurance and not run into medical debt.

As a longtime physician, he has seen the hardship faced by people who have no health insurance coverage, who put off seeing a doctor until their health gets really bad.

But his son, Lawrence, diagnosed at age 3 with moderate to severe autism, has never been without access to health care because he has been on Wang’s employer-sponsored health insurance plan since he was an infant. And but for the sweeping Affordable Care Act (ACA) of 2010, Lawrence would have been kicked off his father’s health plan when he graduated from school last year.

A provision in the ACA that rolled out in September 2010 allows children to remain on their parents’ health insurance plan through their 26th birthday. That provision alone has allowed more than 3 million young adults like Lawrence to have health insurance nationwide, according to the Commonwealth Fund, a leading source of healthcare research.

At the time the ACA was signed into law, some 15 million young adults were uninsured, according to the Department of U.S. Health and Human Services.

Millions of young adults now covered

A survey by the Commonwealth Fund showed last June that 13.7 million young adults between 19 and 25 stayed on or joined their parents’ health plans in the 12 months ending November 2011. This included 6.6 million who likely would not have been able to do so prior to the passage of the ACA.

The survey also showed that young adults in low- and moderate-income households were most likely not to have health insurance. The lack of insurance had significant health and financial implications for them: 60 percent said they did not get needed health care because of cost and half reported problems paying medical bills or said they were paying off medical debt over time.

Prior to the ACA, Lawrence would have aged out of his father’s health insurance plan when he graduated from school last June. Parents could only cover their children until they turned 19, unless they were disabled, or up to their 24th birthday if they were enrolled in college full time.

Under the ACA, young adults can remain on their parents’ plan up to age 26, even if they are out of school, married or living on their own, if they cannot get health insurance through an employer.

This of course means that young adults “will be free to make choices based on what they want to do, not on where they can get health insurance,” U.S. Health and Human Services Secretary Kathleen Sebelius is quoted as saying.

Wang’s eldest daughter, now 27, stayed on his group plan for almost a year after she married.

Insuring young man’s health and future

When Lawrence graduated from school last year, he could have qualified for Medi-Cal, the federal-state funded safety net for low-income people. But Wang said he chose not to enroll him in the program because of the limited number of providers in the network.

“Medi-Cal patients sometimes have to wait for months to see a specialist, and I didn’t want to take that risk,” he said.

Lawrence would not have been able to buy insurance from a private insurer because of his pre-existing health condition. Insurers currently can deny coverage to people with pre-existing health conditions. Starting Jan. 1, 2014, when the health care reform law is fully implemented, insurers will be banned from doing that.

Wang realizes that Lawrence’s autism, which has given him a good ear for music, could keep him from landing a full-time job that provides health benefits. The young man currently works three jobs, each for a few hours a week, and on hourly wages between $10 and $13.

A study in the journal Pediatrics suggests that one in three young adults with autism have no paid job experience years after they graduate from school.

Next year, Wang plans to purchase insurance coverage for his son on Covered California, the online, federally subsidized health care exchange California will launch next January. He wants to insure — literally — the young man’s health and future.

“I will make sure he is covered,” Wang said, adding: “Even when you are young and healthy, it’s best to have insurance. If you get sick or have an accident, the medical bills could be many thousands of dollars.”

This report was made possible by a grant from The California Endowment and is part of New America Media’s series on the Affordable Care Act.