News 5 Investigates

Feb 13, 2014 10:27 PM by Eric Ross

News 5 Guardians: Understanding health care coverage through the child support system

After the passage of the Affordable Care Act, a Colorado Springs mom contacted News 5, asking us to look into how health care factors into the child support system.
With more than 20,000 active child support cases in El Paso County alone, the issue affects a lot of people.

Carrie McDuffee had to find out the hard way how expensive medical bills can be without insurance when her son, Josh, had to be taken to the emergency room.

"He had pleurisy and costochondritis which was inflammation of the chest linings," McDuffee said. "Basically it was $1,500 at the ER for them to do x-rays and give him Tylenol and tell me to wait for it to go away."

Since that expense, she counts her blessings.

"Most of the time I've been lucky," she said. "He's the healthiest kid I've ever met in my life."
In the back of her mind are worries are about what would happen if another incident arises. Josh isn't immune to everything, and is allergic to bees.

"I'm afraid if he gets stung by a bee or if he gets hurt or really sick," she said. " I mean that one time that he had Pleurisy it was scary."

According to court orders, Carrie's ex-husband pays monthly child support. Until Josh was 3-years-old, his father also paid for health care coverage. However, when the job stopped, so did the coverage. Josh is now 12 and by law, is now required to have health insurance.

McDuffee asked, "Who's going to be responsible for paying for health care?"

She turned to the El Paso County Child Support Services office for help.

"They told me basically that because his father pays his child support on a regular basis, that they wouldn't pursue the medical coverage part of it," McDuffee said.

We sat down with Jeff Ball. He is the head of Young-Williams, a company contracted with the Department of Human Services to do child support establishment and enforcement. Ball oversees child support operations in El Paso County.

As Ball explains, a court order contains two elements:
(1) Child support payments
(2) Health insurance payments

"If health insurance is reasonably available from an employer by either the custodial parent or the non-custodial parents employer, then that parent may be ordered to provide health insurance," Ball said.

Prior to the Affordable Care Act, News 5 learned it was at the judge's discretion whether to require a parent to pay for health care.

"There could be situations where the court did not order either party to have health insurance coverage," Ball said.

There is a category for health insurance payments, according to McDuffee's order, but it was left blank. Both parties checked "non-applicable" when asked what health care provider Josh was covered under.

Now that the law has changed, which parent will get penalized for not carrying coverage?
"It is the parent who can claim the child as the dependent who then is responsible for proving that the child has health insurance," Ball said.

This means McDuffee is not required to pay health care costs, but could very well be penalized if she can't prove her son is covered in the event she gets audited.
At this point in time, she says it's just too expensive for her to carry full coverage for Josh through her employer.

"The federal government and the State of Colorado are waiting to see how the Affordable Care Act plays out before they make any definitive ruling as to how we should change our approach on how we do health insurance under the child support laws," Ball said.

As for enforcement, the El Paso County Child Support Services says if health insurance is documented in the current court order, that is enforceable under its jurisdiction. This means not paying for health care carries the same penalties as a parent who fails to pay their portion of child support.

If there's no health care expense in the court order, then it's up to the IRS to follow up and take action.

How do you know whether your current court order contains a health insurance clause?
If you look on the itemized list of expenses enclosed in the court order, it should be listed on item line "5B" or "5C".

You as a parent have the right to contact your local child support office and request adjustments in your current court order.

All court orders issued after the Affordable Care Act passed include payment arrangements for health care costs.


Ball adds that about 80-percent of the cases prior to the Affordable Care Act contain some type of order for health care expenses.

 

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