A widely known—and often praised—provision of the Affordable Care Act (ACA) allows young adults to remain on their parents’ health insurance plan until they reach age 26. Before passage of the ACA, health insurers could remove enrolled children from their parents’ health insurance plan when they reached age 19. The seven-year increase was one of the few points of general agreement among legislators when the law was passed in 2010, in part, because of the increasing numbers of young adults unable to find stable employment with benefits or to afford health insurance coverage on their own. However, as this portion of the ACA has been put into practice, some states and health privacy experts have concluded that the benefit of maintaining coverage through a parent’s health insurance may come with a cost: privacy.

In 1996, Congress passed the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 42 U.S.C.A. §§1320d-1 to -9. After several amendments, Congress enacted 42 U.S.C.A. §1320d-2(d)(1)(A), (d)(2)(A) and (B), which gave the Secretary of Health and Human Services the authority to adopt security standards that “ensure the integrity and confidentiality of [health] information” and protect “against any reasonably anticipated threats or hazards to the security or integrity of the information; and unauthorized uses or disclosures of the information.” These standards—otherwise known as “the privacy rule”—prohibit “covered entities,” 45 C.F.R. §160.103, such as health plans or certain health care providers, from disclosing “protected health information,” 45 C.F.R. §164.512, except under very specific circumstances, see 45 C.F.R. 164.502.

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