Major Changes to Medical Insurance and Child Care Costs Under the 2017 Massachusetts Child Support Guidelines

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Major Changes to Medical Insurance and Child Care Costs Under the 2017 Massachusetts Child Support Guidelines

Health care and child care costs 2017 guidelines

Massachusetts family law attorney Jason V. Owens reviews the major changes to child care and health care costs under the 2017 Massachusetts Child Support Guidelines.

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Attorney Jason V. Owens

For years, the formula for calculating child support in Massachusetts has included adjustments based on the medical insurance and child care costs of each parent. In 2017, Massachusetts finally addressed a persistent problem in the Guidelines formulas: The state took steps to equalize how health care coverage and child care costs expenses are treated for child support recipients and payors, where previous versions of the Guidelines had significantly adjusted child support for paying parties in consideration of these expenses, while providing very little credit when the party receiving child support paid the same expenses.

The 2017 Massachusetts Child Support Guidelines take a much more thoughtful and even-handed approach to medical insurance and child care expenses than previous Guidelines. However, the improved fairness comes at a cost. The state’s new Guidelines worksheet is significantly longer and more complicated as a result of the new approach to cost deductions for child care and health care coverage.

For a complete review of the other changes under the 2017 Guidelines, check out my full-length blog on what is new in the 2017 Massachusetts Child Support Guidelines.

Pre-2017 Child Support Guidelines: Grossly Unequal Treatment of Health and Child Care Costs for Recipients vs. Payors

In 2015, we wrote a blog detailing the unequal way that the 2013 Child Support Guidelines addressed medical insurance and child care expenses for child support recipients and payors. The party paying child support, the blog explained, would receive a reduction in his or her child support payments equal to roughly 20% of his or her weekly medical insurance and child care costs. In contrast, a child support recipient with very high medical insurance and child care expenses would receive almost no increase in his or weekly child support. The blog summarized the problem as follows:

The very different treatment of payor income (and deductions) versus recipient income (and deductions) under the Guidelines proves highly problematic when applied to medical insurance costs. The neat symmetry of the Child Support Guidelines worksheet creates the illusion that medical insurance costs are equally apportioned between parties, but the math tells a very different story. Just as Guidelines treat the incomes of recipients and payors very differently, each party’s deductions from income – such as medical insurance costs – suffer from unequal treatment.

Our 2015 blog focused on medical insurance rather than child care. However, the 2013 Guidelines used the same formula for medical and child care expenses deductions. Thus, all of the criticisms of how the 2013 Guidelines treated medical insurance costs applied equally to how the 2013 Guidelines treated child care cost deductions. In both instances, the 2013 Guidelines gave substantial adjustments in favor of child support payors with major costs while giving very little adjustment in favor of recipients with the same costs.

With respect to medical insurance costs, the solution we suggested in our 2015 blog was follows: each party should each be responsible for paying 50% of the child(ren)’s portion of the medical insurance costs. While this solution was far from perfect, we argued, at least it would eliminate the vastly different treatment that child support recipients and payors received under the 2013 Guidelines when it came to medical insurance costs.

The 2017 MA Child Support Guidelines:  A Comprehensive Approach to Medical Insurance

By 2017, it was clear that Massachusetts needed to adjust how it treated medical insurance and child care expenses, where the increase in these expenses over the last decades had far exceeded the increase in average household income. Simply put, for many parents with young children, medical insurance and child care costs consume a huge portion of their income. It was time for the state’s Child Support Guidelines to make a serious attempt at reform. The changes implemented by the 2016-2017 Massachusetts Child Support Task Force largely succeeded in improving the treatment of health and child care coverage under the Guidelines. The Task Force explained these changes on Pages 15 and 17 of the Guidelines, repeating identical language in the child care and health care coverage sections as follows:

In addition to child care costs, the Task Force also discussed at length how to address the concerns raised by many people regarding the significant costs of health care coverage. The Task Force recommended a proportional adjustment to the child support order based on child care and health care costs. The proportional adjustment for the costs is not dollar-for-dollar because the significant costs of child care and health care coverage could unfairly skew a child support order. Instead, the adjustment is capped, either up or down, at fifteen percent of the child support order.

How Have the 2017 MA Child Support Guidelines Changed the Treatment of Medical Insurance and Child Care Costs?

The 2017 Guidelines uses similar language to describe how cost deductions work in the sections dedicated to Child Care Costs and Health Care Coverage. On Page 10, the Guidelines describe the treatment of child care costs as follows:

Reasonable child care costs for the children covered by the child support order and due to gainful employment of either parent are to be deducted from the gross income of the parent who pays the cost. The guidelines worksheet makes an adjustment so that the parents share the burden of the cost proportionately. The adjustment involves a two-step calculation. First, a parent who is paying the child care deducts the out-of-pocket cost from his or her gross income. Second, the parties share the total child care costs for both parents in proportion to their income available for support. The combined adjustment for child care and health care costs is capped at fifteen percent of the child support order.

Nearly identical language is used on Pages 11-12 in the Health Care coverage section of the Guidelines:

Each parent may deduct from gross income the reasonable cost of individual or family health care coverage actually paid by that parent. …. The guidelines worksheet makes an adjustment so that the parents share the burden of the cost proportionately. The adjustment involves a two-step calculation. First, a parent who is paying the health care deducts the out-of-pocket cost from his or her gross income. Second, the parties share the total health care costs for both parents in proportion to their income available for support. The combined adjustment for child care and health care costs is capped at fifteen percent of the child support order.

In plain English, the 2017 Guidelines does remove the method for deducting costs under the 2013 Guidelines. Instead, the 2017 Guidelines place a new calculation on top of the method used in 2013. Thus, if one compares a 2013 Guidelines worksheet with a 2017 Guidelines worksheet, one sees that the section where parties initially deduct their child care and health coverage costs from gross income are identical, but the 2017 Guidelines includes a new section entitled “Adjustment for Child Care and Health Care”:
2013 vs 2017 MA Child Support Guidelines

The Adjustment for Child Care and Health Care Under the 2017 Guidelines

As we will further discuss below, the 2017 Guidelines have significantly increased in complexity as a result of the adjustment for medical insurance and child care costs. Without diving too deeply into the math, we can say that the new adjustment is based on two main principles:

  1. The higher earning party should pay a proportionately larger share of the combined child care and health coverage costs of the parties. In essence, the 2017 Guidelines say that if one party earns 90% of the income, then that party should pay a large share of the other party’s child care and health insurance costs. If the richer party is the child support payor, he or she pays more child support to help cover the less wealthy recipient pay these costs. If the richer party is the recipient, child support will be reduced so the payor can better cover the costs him or herself.
  2. The adjustment to child support for child/medical costs is capped at 15% of the overall child support order. In order to avoid scenarios where child support becomes wildly skewed due to one party’s very high child care or health care costs, the Guidelines limits the adjustment.  In short, if the base child support order is $100 per week, the adjustment for child/medical costs will be no more than $15 upwards or downwards.

But How Does It Really Work? Examples of the 2017 Guidelines Adjustment for Child and Health Care Expenses

Here is the part you have been waiting for, dear reader. What really matters about the changes to child care and medical insurance expenses under the 2017 Guidelines are the real-world consequences. The only way to show the real world consequences are direct comparison between the 2013 and 2017 Guidelines.  Let’s get to it.

Hypothetical 1. Recipient Earns $1000/wk, Payor earns $2000/wk, and Recipient has $300/wk in Costs

Scenario 1: We will start with a typical scenario in which the child support payor earns twice as much as the recipient, but the recipient has $300/wk in child care or health care costs.

Base Support: Under both the 2013 and 2017 Guidelines, base child support would be $377/wk if the neither party had cost deductions for child care or health care coverage.

Analysis: Base support would be $377/wk if neither party had cost deductions. Under the 2013 Guidelines, child support increases by $5/wk from base support to $383/wk if the recipient is assigned $300/wk in child or health costs. Under the 2017 Guidelines, child support increases by $63/wk from base support to $440/wk if the payor is assigned $300/wk in cost deductions.

Bottom Line: Under the 2013 Guidelines, child support is $383/wk. Under the 2017 Guidelines, child support is $440/wk. Child support has increased by $57/wk under the 2017 Guidelines compared to the 2013 Guidelines.

Hypothetical 2. Recipient Earns $1000/wk, Payor earns $2000/wk, and Payor has $300/wk in Costs

Scenario 2: This is identical to Scenario 1, but we have now assigned the $300/wk in costs to the payor.

Base Support: Under both the 2013 and 2017 Guidelines, base child support would be $377/wk if the neither party had cost deductions for child care or health care coverage.

Analysis: Base support would be $377/wk if neither party had cost deductions. Under the 2013 Guidelines, child support decreases by $51/wk from base support to $326/wk if the payor is assigned $300/wk in child or health costs. Under the 2017 Guidelines, child support decreases by $100/wk from base support to $277/wk if the payor is assigned $300/wk in cost deductions.

Bottom Line: Under the 2013 Guidelines, child support is $326/wk. Under the 2017 Guidelines, child support is $277/wk. Child support has decreased by $49/wk under the 2017 Guidelines compared to the 2013 Guidelines.

Hypothetical 3. Recipient Earns $2000/wk, Payor earns $1000/wk, and Recipient has $300/wk in Costs

Scenario 3: Under the next two scenarios, the recipient of child support earns twice as much as the payor. To start, the recipient has $300/wk in child care or health coverage costs.

Base Support: Under both the 2013 and 2017 Guidelines, base child support would be $186/wk if the neither party had cost deductions for child care or health care coverage.

Analysis: Base support would be $186/wk if neither party had cost deductions. Under the 2013 Guidelines, child support decreases by $6/wk from base support to $192/wk if the recipient is assigned $300/wk in child or health costs. Under the 2017 Guidelines, child support increases by $34/wk from base support to $220/wk if the payor is assigned $300/wk in cost deductions.

Bottom Line: Under the 2013 Guidelines, child support is $192/wk. Under the 2017 Guidelines, child support is $220/wk. Child support has increased by $28/wk under the 2017 Guidelines compared to the 2013 Guidelines.

Hypothetical 4. Recipient Earns $2000/wk, Payor earns $1000/wk, and Payor has $300/wk in Costs

Scenario 4: Now the payor has $300/wk in child care or health coverage costs.

Base Support: Under both the 2013 and 2017 Guidelines, base child support would be $186/wk if the neither party had cost deductions for child care or health care coverage.

Analysis: Base support would be $186/wk if neither party had cost deductions. Under the 2013 Guidelines, child support decreases by $51/wk from base support to $135/wk if the recipient is assigned $300/wk in child or health costs. Under the 2017 Guidelines, child support increases by $74/wk from base support to $112/wk if the payor is assigned $300/wk in cost deductions.

Bottom Line: Under the 2013 Guidelines, child support is $135/wk. Under the 2017 Guidelines, child support is $112/wk. Child support has decreased by $28/wk under the 2017 Guidelines compared to the 2013 Guidelines.

Comparison Overview: Both Recipients and Payors Benefit Under 2017 Guidelines

The examples provided above show the unequal treatment between payors and recipients under the 2013 Guidelines.  In Scenarios 1 and 2, we saw that adding $300/wk in cost deductions for the recipient only changed child support by $5/wk, while adding $300/wk in cost deductions for the payor changed child support by $51/wk. Similarly, in Scenarios 3 and 4, the 2013 Guidelines provided the recipient with a $6/wk increase compared to providing a payor with a decrease of $51/wk for identical deductions of $300/wk.  In short, cost deductions for child care or health coverage under the 2013 Guidelines gave payors about 10x more benefit than recipients for identical cost deductions.

The 2017 Guidelines do not completely eliminate the favoritism towards payors when it comes to child/health deductions. In Scenarios 1 and 2, the recipient received increased child support of $63/wk for his or her $300/wk in cost deductions under the 2017 Guidelines, while the payor received a decrease of $100/wk for the same deductions. In Scenarios 3 and 4, the recipient received $34/wk in extra child support for $300/wk in cost deductions under the 2016 Guidelines, while the payor received a decrease of $74/wk for the same deductions.  In short, under the 2017 Guidelines, payors continue to receive about 2x the benefit compared to recipients for the same cost deductions in our examples.

In addition to preserving some of the favoritism towards payors, the 2017 Guidelines helped the bottom-line of payors more directly.  In Scenario 2, we saw the payor enjoy a decrease in child support of $51/wk under the 2013 Guidelines grow to $100/wk under the 2017 Guidelines. In Scenario 4, the 2013 Guidelines provided a decrease of $51/wk while the 2017 Guidelines decreased child support by $74/wk. In short, even as the 2017 Guidelines closed some of the gap between recipients and payors when it comes to cost deductions, the bottom-line results for payors also improved. In many cases, payors can expect the reduction in child support for child and health costs under the 2017 Guidelines to double compared to the reduction under the 2013 Guidelines.

Risks and Pitfalls: The Unregulated Cost of Child Care

In general, the 2017 Guidelines have greatly improved the fairness of how Massachusetts calculates child support when parents have substantial child care or health care coverage. This doesn’t mean that the new method is risk-free, however. Of particular concern is that child care costs vary wildly from case to case in Massachusetts. A teenage babysitter might cost $15/hour while a high-end daycare center could easily run $200/day.

Further complicating matters is the murky distinctions between preschool and daycare. Studies seem to overwhelmingly support the importance of pre-K education for children. In America, however, public kindergarten is often unavailable until after a child turns 5 years old. Into this gap steps early learning centers that often blend aspects of daycare and preschool to the point of obscurity. Should the cost of a child’s enrollment at an early learning center be split between the parties equally, like many other educational costs, or should such costs be treated as child care expenses of one party, with a much smaller offset from child support to cover that party’s costs?

A child’s ability to attend public school is largely a function of residence. Most parents have a very small menu of choices when it comes to sending their child to public school. Similarly, eligibility for medical insurance is often restricted to employer-based plans or state-subsidized plans.  In stark contrast, a parent can enroll a dozens of preschools, daycare centers or mixed early learning centers, where the price of attendance can vary widely.

Clearly, the cost of child care is a huge issue in Massachusetts and America, particularly as more and more single parents work. However, it seems likely the increased adjustments to child support that parents will receive for child care costs under the 2017 Guidelines will lead to litigation and controversy over what constitutes an appropriate child care expense, how parents should choose child care providers, and whether parents should be forced to contribute to high child care costs incurred by opposing parties without notice or consent.

The Cost of Progress: Increased Complexity in the 2017 Guidelines Formula and Worksheet

In general, the 2017 Guidelines have greatly improved the fairness of how Massachusetts calculates child support when parents have substantial child care or health care coverage. This progress comes at a cost, however.  As illustrated in the graphic above, the 2017 Guidelines worksheet is roughly three times as long as the 2013 worksheet, and includes much more complex math. Obviously, online calculators and iPhone apps that will “do the math for you” help compensate for the added complexity, but we know low-income and unrepresented parties will struggle mightily filling out the new forms. (It is worth noting that many large court locations, such as the Brockton Probate and Family Court, prohibit parties from bringing smartphones into Court. The internet and iPhone apps that can calculate the new Guidelines are useless if parties cannot access the devices they need to enjoy such tools.)

The main drawback to the added complexity in the 2017 Guidelines will be the additional pressure the new calculations place on court staff, including family service officers, to generate Guidelines worksheets on behalf of parties in nearly every case that does not feature an attorney. With Probate and Family Courts always at the mercy of chronic state cutbacks and funding shortages, the new burden will fall on overworked court staffers who already struggle beneath a tidal way of self-represented parties.

The added complexity of the 2017 Guidelines worksheet reflects many broader concerns in American society surrounding automation, complexity and efficiency. For many parties, the new Guidelines will increase fairness and ease financial burdens as a result of the smart new “algorithm”. By same token, the complexity of the formula means that even judges and attorneys will struggle to understand why and how the Guidelines work the way they do.

About the Author: Jason V. Owens is a Massachusetts divorce lawyer and Massachusetts family law attorney for Lynch & Owens, located in Hingham, Massachusetts.

Schedule a free consultation with Jason V. Owens today at (781) 741-5000 or send him an email:

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By | 2017-09-12T10:43:52+00:00 August 31st, 2017|Categories: Child Support, Family Law, Modification, News, Updates|Tags: , , , |Comments Off on Major Changes to Medical Insurance and Child Care Costs Under the 2017 Massachusetts Child Support Guidelines

About the Author:

Jason V. Owens is a Partner and Senior Counsel at Lynch & Owens, and is a frequent contributor to the Lynch & Owens Blog on subjects including Massachusetts divorce, child custody and support, domestic violence, equity and estates litigation, and complex financial probate and family litigation. Attorney Owens can be reached by phone at (781) 741-5000 or email [email protected], or visit his bio page under https://lynchowens.com/attorneys/.