Many parents stick with jobs just to keep sick kids covered

The researchers also looked at how likely working parents with a sense of job lock were to have fair or poor mental health or fair or poor physical health.

About 3.6% of the parents with healthy children and no sense of job lock said they had mental health problems, and 4.5% had physical health problems.

For parents with sick children and a sense of job lock, the risk of having either mental health problems or physical health problems was about 10%.

For parents with a sense of job lock and sick children who had "emotional, behavioral or developmental problems," the risk of having mental health problems was 16%. About 13% of those parents had physical health problems.

Tiffany Lemon and three other researchers at Arizona State University conducted the study. They came up with the figures by analyzing data from National Survey of Children's Health data collected from 2016 through 2023.

The researchers estimated that 20% of U.S. children have either complicated medical needs or emotional, behavioral or developmental problems.

What it means: Lemon and the other researchers suggest that, for parents of children who need extra, complicated care, policymakers should consider providing "universal, continuous insurance coverage over the life course" for both the parents and the children.

Otherwise, "U.S. adult caregivers may increasingly find themselves 'stuck' and faced with difficult choices that may shape the health of their dependents and, possibly, their own health," the researchers conclude.

The backdrop: Even parents of healthy children face challenges coping with children's ordinary battles with colds, stomach bugs and teething pain.

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Employers have been experimenting in recent years with benefits and programs designed to support employees with children with serious illnesses or lifelong special needs.

Human resources and benefits experts have warned employers about the risk that caring for children with serious illnesses or special needs can hurt the caregivers' own health.

Job lock history: Years ago, health insurers' medical underwriting could keep parents who left employer-sponsored health plans from getting any commercial health coverage for children with serious health problems.

The Health Insurance Portability and Accountability Act of 1996 and the Affordable Care Act of 2010 were supposed to make it easier for people with health problems to leave their employers.

Since the HIPAA benefits portability rules took effect, even workers with serious health problems have had a relatively easy time moving from one employer health plan to another.

The ACA helps workers who leave employer plans buy individual or family coverage from HealthCare.gov or another ACA public health insurance exchange.

But the HIPAA and ACA rules do not eliminate job lock concerns for the parents of children who need complicated care, because "having insurance coverage does not guarantee access to care," Lemon and her colleagues write. "Many U.S. youth are underinsured and subject to high out-of-pocket expenses, limited physician networks, suboptimal benefits, and sparse coverage for specialty care."

Employer coverage is usually better the Medicaid coverage or other public health programs, but the drawback of using that coverage is that dependent-related job lock might limit working parents' ability to leave undesirable jobs, change industries, or take career risks, the researchers add.