Long before the adoption of the Federal Affordable Health Care Act , state statutes were enacted to mandate health care coverage for children subject to child support orders. Ohio, for example, granted jurisdiction to divorce courts to order one or both parents to provide health care coverage for their children as part of support orders. The cost of the insurance was to be prorated as part of the typical child support guideline calculation.
In 2008, Ohio adopted new procedures for providing health care coverage for children of divorcing parents. Health care includes not only insurance premiums, but also co-payments, deductibles, and payment of uncovered medical expenses. If insurance is available to a parent at what is deemed to be a reasonable cost, the parents share the cost in proportion to their incomes. The court or support agency must determine if there is private health care coverage, as defined by statute, available to one or both of the parents at a reasonable cost.
When there is no private health care coverage available, an additional monetary order known as a cash medical order is made part of the child support guideline calculation. As when private insurance is available, the amount required to be paid under the cash medical order is prorated between the parents based on their incomes. The child support guideline calculation includes two separate figures. One is the support order without consideration of a cash medical order and the second, support plus the allocation of a cash medical order. The calculation to arrive at the amount of the cash medical order considers the parties' income as it relates to the federally established poverty level. There are computer programs available to make the calculation and incorporate it into child support guidelines.
While the process of providing health care for children of divorcing parents is complicated, the objective remains as protecting the best interest of children. Their medical needs and the costs thereof, must be provided for.