A new frontier in the era of health reform: Protecting confidentiality for individuals insured as dependents.

Billing and claims processing procedures widely used in private health insurance routinely albeit inadvertently make it impossible for anyone insured as a dependent on someone else’s policy to obtain sensitive services confidentially. One of the most frequent ways in which disclosure occurs is through explanation of benefits (EOB) forms sent by insurers to policyholders after anyone covered under their policy obtains care. An EOB typically identifies the individual who received care the health care provider and the type of care obtained. It also includes information on the amount charged for the care the amount reimbursed by the insurer and any remaining financial obligation on the part of the policyholder or patient. The longstanding practice of sending EOBs essentially makes it impossible for dependents -- often minors and young adults -- to obtain the confidential access to sexual and reproductive health care they need. Millions of Americans are expected to obtain health insurance coverage as a result of the Affordable Care Act (ACA) including large numbers of young adults who can now remain covered as dependents under a parent’s policy until age 26. This means that addressing the longstanding challenge of how to protect dependents’ confidentiality about sensitive health services is becoming increasingly important. Historically states have had the lead role in regulating health insurance including whether and to whom insurers must send EOBs. Accordingly some creative ideas already are starting to bubble up from states. These approaches may lead the way to simple workable solutions that satisfy the needs of insurers protect policyholders from unexpected financial exposure and most importantly facilitate access to confidential sexual and reproductive health care for all covered individuals including dependents. (Excerpt)