By JoAnne Belisle

Three years ago, the Young Invincibles team cheered triumphantly when the Affordable Care Act became law. Since then, an estimated 3.1 million young adults took advantage of the provision in the law that allows them stay on their parents’ health insurance plans until age 26. Getting more people access to health care is huge. But what happens when greater access doesn’t include privacy?

Before coming to YI, I worked at a domestic violence clinic, helping victims of domestic abuse request restraining orders. Many of my clients were afraid to seek medical treatment for fear that their abusers would find out through insurance statements. As a result, their injuries went untreated, unreported, and undocumented. A major exception to existing state and federal privacy healthcare laws allows providers and insurance companies to disclose protected health information to the policyholder for payment purposes.

Fearing that a parent or partner will find out, young adults may forego care or treatment for sensitive health issues including STDs, birth control, drug treatment, or mental health services that are covered by their insurance. Others may go outside their insurance network for services, incurring additional expenses or increasing state costs.

I know what this looks like firsthand. Shortly after getting married, I went to the dentist. About a week later, the insurance company sent an explanation of benefits in the mail. Because I am a dependent on my husband’s policy, the statement was addressed to him, the policyholder. The statement included an itemized list of the services I had received – cleaning, exam, x-rays – explaining the charges and what was covered. But what if it hadn’t been a trip to the dentist for a routine cleaning? What if the statement had contained sensitive information that I wasn’t ready to share?

Unlike many policy hurdles, there is a relatively simple solution. Current proposed legislation in California tries to close these loopholes, expanding confidentiality to protect young adults who are insured under another person’s plan and ensuring that privacy rights are a part of coverage. The bill clarifies to whom insurance companies can send explanations of benefits and other communications containing confidential health information. Under the bill, health information for adults under 26 will automatically be kept confidential, unless the patient expressly grants permission to release the information. Additionally, adults over 26 may request that information not be disclosed if it relates to sensitive services or feel that they may be endangered by disclosure. Individuals may even request that insurance communications be sent to an alternate address.

Extending and clarifying health privacy protections is important to ensure that the privacy rights of young adults are properly protected.

How would this change impact you?