The Patient Protection and Affordable Care Act (ACA) mandates that all health insurance carriers in every state that offer coverage to both adults and their dependents must allow dependents to remain on their parents or guardians’ “family” plans until the dependents are 26 years old.

The issued regulations state that young adults are eligible for this coverage regardless of any, or a combination of any, of the following factors: financial dependency, residency of the young adult, student status, employment status, or marital status. This applies to all plans in the individual market and to almost all employer plans (small group, large group, including self-funded or so-called ERISA plans) created after March 23, 2010.

PPACA & HCERA; Public Laws 111-148 and 111-152: Consolidated Print

‘‘SEC. 2714. EXTENSION OF DEPENDENT COVERAGE.

‘‘(a) IN GENERAL.—A group health plan and a health insurance issuer offering group or individual health insurance coverage that provides dependent coverage of children shall continue to make such coverage available for an adult child until the child turns 26 years of age. Nothing in this section shall require a health plan or a health insurance issuer described in the preceding sentence to make coverage available for a child of a child receiving dependent coverage. [As revised by section 2301(b) of HCERA]

‘‘(b) REGULATIONS.—The Secretary shall promulgate regulations to define the dependents to which coverage shall be made available under subsection (a).

‘‘(c) RULE OF CONSTRUCTION.—Nothing in this section shall be construed to modify the definition of ‘dependent’ as used in the Internal Revenue Code of 1986 with respect to the tax treatment of the cost of coverage.”

More Information Are you a parent or young adult seeking more information on health insurance coverage provisions for young adults in the Affordable Care Act? Read the 2016 White House's answers to the most frequently asked questions and a White House fact sheet on the topic. Also read the Department of Labor's answers to frequently asked questions for additional information on the details of coverage for young adults. If you have specific questions about health insurance coverage for young adults discuss them with your employer's benefits manager or contact your state's department of insurance.

The States’ Role

The extension of coverage for young adults under their parents’ or guardians’ health insurance plans, like many of the ACA’s provisions, originated in state legislatures. Prior to the implementation of the ACA, at least 31 states required carriers to extend coverage to young adults. The age at which insurers were no longer required to provide coverage to young adults under their family plans varied by state. Additionally, some states required certain conditions to be met by young adults in order to be eligible for coverage under their guardians’ plans. For example, a number of states required that young adults be unmarried in order to qualify.

States may continue with current state law requirements for extended dependent coverage unless they prevent the application of the ACA. As with other state health insurance statutes, the state mandate language enables the state insurance departments to educate the public, and to implement and enforce those laws directly, including use of state courts and state-specific penalties.

State and local governments, as employers and sponsors of coverage plans, are required to notify those under the age of 26 whose coverage has ended or who were denied coverage under their plans before turning 26, of enrollment opportunities.

State Actions

The federal ACA law applies to young adults in all states.

As of 2012, (before the ACA was fully in effect) the following 37 states had already extended the age that young adults can remain on their parents' health insurance plan: Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin and Wyoming.

There is considerable variation among state laws in terms of eligibility requirements. At least 30 states have extended dependent coverage, regardless of student status. Most states require that a young adult be unmarried and financially dependent on their parents in order to qualify for extended dependent coverage.

States may continue to apply current state law requirements for extended dependent coverage except to the extent that the requirements prevent the application of the Patient Protection and Affordable Care Act (ACA). [Reviewed/updated 2016]

The box allows you to conduct a full text search or type the state name.

Coverage Beyond the Federal ACA | 2016 update

Six states, including Florida, Illinois, New Jersey, Pennsylvania, South Dakota and Wisconsin have enacted laws that require or authorize carriers to cover young adults beyond age 26. New York and Ohio previously enacted such laws, however those provisions are no longer in effect.

State Laws Beyond ACA State Required Coverage Age Cut-off Citation Florida 30 (must be unmarried and have no dependents of their own) West's F.S.A. § 627.6562 Illinois 30 (applies to Veterans only) 215 ILCS 5/356z.12 New Jersey 31 N.J.S.A. 17B:27-30.5 New York 29* (unmarried and not eligible for employer-based insurance) McKinney's Insurance Law § 3216 Pennsylvania 30 40 P.S. § 752.1 South Dakota 29* SDCL § 58-17-2.3 Wisconsin Full-time students, regardless of age Wis. Stat. § 632.885

Who Pays?

The cost of notifying families about new enrollment opportunities is shared between insurance providers and employers. The cost of covering the young adults who take advantage of the extension is shared between employers and the families of newly covered young adults. For families with no employer health coverage, the cost may fall on the parents. Those families that qualify for States, as sponsors of coverage plans for state employees, also share the costs with families. A qualified young adult cannot be required to pay more for coverage than similarly situated individuals who did not lose coverage due to the loss of dependent status.

IRS Notice 2010-38 provides guidance to extend the general exclusion from gross income for the reimbursements for medical care under an employer provided accident or health plan to any employee's child who has not yet attained age 27 as of the end of the taxable year, making the benefit tax-free.

*The information on this page is intended for state policy makers. It is not intended as legal or medical advice or guidance to individual insurance enrollees..

Source: NCSL legal research, 2016; State Health Facts by KFF. Legal review, 2011-2015: Richard Cauchi, NCSL Health Program.

Update 2016 research: Ashley Noble, J.D., NCSL Health Program