HD32 - The Social and Financial Impact and the Medical Efficacy of House Bill 883: Mandated Health Insurance Coverage of Adoptive Children

  • Published: 1991
  • Author: Special Advisory Commission on Mandated Health Insurance Benefits
  • Enabling Authority: Code of Virginia - § 9-299

Executive Summary:
The Special Advisory Commission on Mandated Health Insurance Benefits (Advisory Commission) was established by the 1990 Virginia General Assembly to advise the Governor and the General Assembly on the social and financial impact of current and proposed mandated benefits and mandated providers. Senate Bill 478 and House Bill 1106 added sections 9-297 through 9-300 to Chapter 34 of Title 9 and thereby created the Advisory Commission. The Advisory Commission is required to provide assessments of proposed and existing mandated benefits and providers and other studies of mandated benefits and provider issues as requested by the General Assembly.

House Bill 883 was proposed during the 1990 session of the General Assembly to require that all insurers, health services plans and health maintenance organizations (HMOs) provide coverage to adopted children if the contract provides coverage for family members. The bill was carried over during the 1990 session because of the creation of the Advisory Commission.

House Bill 883 was the first bill assessed by the Advisory Commission. It was the subject of a public hearing on September 12, 1990 and deliberations on December 10, 1990.

The Virginia Insurance Code does not use the terms "biological" or "adoptive" in reference to children. Rather, the term "dependent" is used. This term is not defined in the Code. It is defined in the insurance contract. Many insurance contracts do not distinguish between adopted or biological children. The question as to when coverage begins (time of placement versus time of finalization of adoption) is not regulated by the insurance code. The company's practices and contract (policy) language are the determining factors. Insurers' practices vary greatly regarding when coverage begins. Many insurers presently begin coverage from "the time of placement in the insured's residence". Some companies, however, require that the adoption be final before beginning coverage.

The Advisory Commission reviewed information prepared by staff as well as opponents and proponents of the mandates before making its decisions. The Advisory Commission's main concerns were that there be equitable treatment of adoptive and biological children and uniformity of coverage by companies.

The Advisory Commission unanimously recommends that coverage of adoptive children be mandated, if the policy or contract provides coverage for family members, from the date the child is placed for adoption. The Advisory Commission recommends that a child placed within 31 days of birth be considered a newborn child of the insured. The Advisory Commission does not recommend that underwriting practices for adoptive children be limited in any manner that is inconsistent with the underwriting of biological children.

The Advisory Commission believes that the equitable treatment of adoptive and biological children is in the public's best interest. The Advisory Commission also believes that the cost of mandating coverage from the time of placement does not place any undue burden on insurers or policyholders.