Most 23-year-olds probably wouldn’t want their parents to receive a letter in the mail about an HIV test they took last week.
But, if they’ve opted to remain covered on their parents’ insurance until the age of 26, that’s exactly what can happen to them when they use their plan. One of the most popular provisions under Obamacare has created somewhat of a loophole in our nation’s current health privacy laws.
Millions of young adults are taking advantage of their new coverage options under Obamacare, but that comes with some unintended consequences for their sensitive sexual health information. Insurers are typically in regular communication with a plan’s main policyholder, giving that person detailed information about how their plan is being used. For instance, policyholders receive regular Explanations of Benefits (EOBs), which are summaries of exactly what happened at recent doctors’ visits. So, in families where young adults remain covered through their early 20s, parents will be able to tell whenever their kids fill a birth control prescription, take a pregnancy test, receive treatment for an STD, or get an abortion.
There’s a simple fix to this, and one state is forging the path forward. Thanks to a new law in California that takes effect this month, people in the Golden State will be able to indicate that they want the information about their sensitive health data sent straight to them, instead of to the person who holds the policy.
California was the first state in the country to pass legislation specifically addressing this health privacy issue under Obamacare. On January 1, after giving insurance companies a year to prepare for it, the Confidential Health Information Act officially became law — marking a victory for the advocates in the state who helped push for the policy.
“The Confidential Health Information Act will make sure that individuals with health insurance under another person’s policy feel safe enough to use it,” Amy Moy, the vice president of public affairs for California Family Health Council, one of the groups that co-sponsored the legislation, told ThinkProgress.
Previous research has confirmed that insured young adults often pay out of pocket for reproductive health services, like birth control and abortion, instead of using their plans. They typically opt to do that because it offers more privacy, even though it costs more money. However, if young women can’t afford the full cost of the services they need, it’s possible they may skip out on health care altogether.
“We know from our work in the community that there are young folks who will go to their college health clinic and say no to that HIV test, or say no to pregnancy counseling services, because they know it will show up on a parent’s insurance bill,” Rebecca Gudeman, a senior attorney at the National Center for Youth Law, another co-sponsoring organization, told ThinkProgress. “We think the law is really going to make a huge impact pretty quickly.”
With the security of knowing an itemized bill won’t appear on their parents’ doorstep, more young adults may feel comfortable seeking out preventative sexual health services. California’s legislation also has implications for other types of sensitive care, like mental health treatment or drug and alcohol counseling. And it could make victims of domestic violence more comfortable going to the doctor, since their health data will be protected from their abusive partner.
Now, advocates like Moy and Gudeman are trying to get out the word. They’ve set up a website explaining how to submit the form that requires insurers to redirect sensitive health information, started training medical providers on the change, and partnered with campus health centers.
And they’ve also been thinking about how to help the policy spread to other states. According to Moy, since California’s law was passed and signed, her organization has been in talks with advocates in more than 20 other states who have expressed interest in the legislation. One of those states, Maryland, passed its own version of the Confidential Health Information Act last year.
“We’re really excited that this could be a potential model for other states to adapt,” Moy said. “We have some of the biggest national health plans operating in the state of California — so our hope also is that, now that the health plans have to do it in California for a large number of their clients, they’ll already have a system in place.”
“People are recognizing that this issue of confidentiality is a problem and has really been a barrier to care. So there are people looking for solutions, and if we can show this makes a difference in access to health care, I do think this will spread quickly,” Gudeman agreed. “It’s a win-win for everyone if we can get preventive care out there to the people who want it and need it.”