Does Obamacare Require That Retiree Health Plans Cover Children up to Age 26? – NO



PRO (yes)


[Editor's Note: Based upon a neutral reading of the Patient Protection and Affordable Care Act and bi-partisan third party analysis, this question seems to have a clear and obvious Con (no) answer, and ProCon.org has therefore presented the responses in a single column with no opposing perspective.]




CON (no)

The Segal Company, a consulting firm, stated in its Apr. 25, 2012 posting "Proposed Rule on the Affordable Care Act's Comparative Effectiveness Research Fees," available at its website:

"[R]etiree-only plans do not have to comply with many provisions in the Affordable Care Act (e.g., the group health plan standards, such as continuing coverage for dependent children to age 26)."




Maurice Hinchey, US Representative (D-NY), posted in his Nov. 1, 2011 press release "New Hinchey Bill Would Allow Parents with Retiree Health Plans to Extend Insurance Coverage to Children Up to Age 26," available at his website:

"Retiree-only plans were exempted from many of the provisions of the Affordable Care Act, including the dependent coverage provision that allowed children to stay on their parents' health care plan through age 26."




Annie L. Mach, Analyst in Health Care Financing at the Congressional Research Service, and Bernadette Fernandez, Specialist in Health Care Financing at the Congressional Research Service, wrote in their Nov. 1, 2011 study "Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA)," available at www.crs.gov:

"[F]or certain plans the ACA market reforms, as well as other federal health reforms, do not apply. For example, retiree-only health plans are not required to comply with federal health insurance requirements, such as the dependent coverage requirement."




Ellen E. Schultz, Investigative Reporter for the Wall Street Journal, and Jessica Silver-Greenberg, Money & Investing Reporter for the Wall Street Journal, wrote in their Oct. 9, 2010 article "Health Overhaul Overlooks Retirees," available at the Wall Street Journal website:

"Thanks to a little-noticed clause in a 1996 law, retiree-only health plans are exempt from the Patient Protection and Affordable Care Act that went into effect last month.

That means the rule requiring health plans to extend dependent coverage to age 26, regardless of financial dependency, student status, employment or marital status, doesn't apply to millions of retirees' health benefits."