Dear BMull:
Nice post.  Here are my first thoughts.  First, in the traditional model, this is not a problem.  Noncustodial parent makes more and is responsible for health insurance, that parent's percentage of uninsured medical expenses, and gets the child(ren)'s personal exemption(s) and child tax credit(s).  The noncustodial parent's child support is reduced by the net cost to the noncustodial parent (family premium minus single premium) times the custodial parent's child support income percentage to the combined child support income.  For example, custodial parent's csi is $2,000.00, noncustodial parent's is $4,000.00, 1 child middle age category, and noncustodial parent's base child support is $610.59.  Noncustodial parent's family premium is $100.00 and single coverage is $25.00.  The $75.00 premium difference is multiplied by the custodial parent's % of 33.33% to reduce child support to $610.59 minus $75.00 *33.33% or $610.59 minus $25.00 or $585.46.
This way the noncustodial parent gets to keep track of the child's medical history and the custodial parent reports any uninsured expenses to the noncustodial parent for prompt payment.
Second, in the inverted model, this is not a problem.  Custodial parent makes more and is responsible for health insurance, that parent's percentage of uninsured medical expenses, and keeps the child(ren)'s personal exemptions(s) and child tax credits(s).  Noncustodial parent child support is increased to pay for the difference in premiums from family to single at the noncustodial parent's percentage.
Obviously there is a problem where the child(ren)'s health insurance is not paid by the parent claiming the child(ren)'s personal exemption(s) and child tax credits.  I will discuss that later.
djmlaw

djmlaw,

What is being done in court right now to address this issue?  I know many on this forum currently alternate the tax benefit.  But of course, they're not going to alternate the healthcare.  So what is a judge to do about this before any of this mess is sorted out?

Worst fears recognized as far as complications.  Custodial parent with 2 children and agi of $3,000.00/month.  Bronze plan for family is $350.92/month with tax credit of $183.58 for net cost of $167.34.  Parent with no children and same agi has no government tax credit and premium of  $154.58.  Thus I would take $350.92 minus $154.58 for cost of medical insurance for children so a net premium of $196.34 for children.  Subtract the tax credit of $183.58 and the custodial parent's net net premium is $196.34 minus $183.58 or $12.76 rather than the previously reported $167.34.  Custodial parent should not have to subsidize custodial parent's portion of premium.  I am going home for the day.
djmlaw

The cost of your child's health insurance is handled no differently under Obamacare than any time before. It will not require any changes to the Child Support Guidelines and is a Federal Law, not a State Law. So, Kansas can not change it.

The IRS will simply be recording whether or not your child(ren) is/are insured.

Applying for a policy through the Obamacare program is a separate matter and uses your AGI from the previous tax year to determine the cost basis for any policy you might purchase. I would think that the greatest challenge facing the District Courts in that regard is the challenge of separating out the cost of coverage for the children from the rest of the family members. The Federal Programs do not separate things out that way and there is not an easy way for a policy holder to get that information. You must choose which option you want before getting a cost quote. This would effect the Child Support worksheet adjustments and calculations.

Your children do not need to be your tax deductible dependents for you to be able to purchase insurance for them and is now by law available until age 25 (26?). The government does not care who pays for it. In some cases it may be a fully provided company benefit at no cost to an employee from an employer. Although that is becoming more and more rare. I have never had an insurance provider require me to provide proof that a child was my dependent through documentation (i.e. Birth Certificate, Adoption papers, Social Security card, tax  filings) so long as I named them as a dependent and paid the premiums.

I forgot to mention that I think if there really is a problem here, people in Kansas won't really be fully aware of it until April 15th, 2015.  The new laws that I speak of went into effect on Jan 1, 2014.  If a parent claims a child as a dependent but doesn't provide the healthcare, they are penalized based on their income.  That penalty would then generate motions to modify child support about this time next year.  So, I'm simply trying to ascertain if this is really a concern, if the proper tax forms are available and address this issue, and what the process is.

Dear BMull (March 11, 2014, 11:22:28 p.m. post):
Be a little careful with your example.  Here are the general rules:
1.  Either parent can get private health insurance for any of that parent's minor child.  The child need not live with the parent providing health insurance.
2.  Only the custodial parent can get public (Medicaid & CHIP) health insurance for the children living with that parent.
3.  If there is no health insurance coverage for a child and there should be, then the parent actually claiming the child is liable for the IRS penalty.
4.  Most insurance plans have a subsidy element in them.  I will call the full premium the "full premium."  For example, Boeing's cost to cover a single person with  health insurance might be $1,234.56/month but Boeing only charges the "actual premium" of $567.89/month.
5.  If the children are covered through either parent's action, then there is no Obamacare penalty to either parent. 

If the parents have health insurance coverage for the child, then the Guidelines formula kicks in with a child support adjustment if the parent has an out-of-pocket cost in covering the child.  In general, the public health insurance plans have no premium cost or the cost is low and so if the custodial parent qualifies, the best plan is for the usually lower income custodial parent to get the public health insurance with an "actual premium" of zero and transfer the dependency exemptions to the higher income noncustodial parent who can better use it.  Since there is no out-of-pocket costs for the premium, the Guidelines don't adjust the child support.  [Note:  Usually low income custodial parents can easily get health insurance for their children but can't qualify for any subsidies once their children get put into Medicaid or CHIP because Medicaid is so low and the Obamacare subsidies start at the federal poverty level for the family size.]

The Guideline problem with the state health insurance exchanges is that the "actual premium" cost for a family plan including the custodial parent and the children has a very heavy subsidy in favor of covering the children.  For example, the "full premium" might be $700/month but the custodial parent gets a credit against this premium of $500/month so that parent only needs to pay an "actual premium" of $200/month to the insurance company and Uncle Sam pays $500/month to the insurance company.  So far, so good in that the custodial parent's "actual premium" is a well defined $200/month.

But the "full premium" of $700/month covers both the custodial parent and the children.  The Guidelines are going to have to "tease out" from the $200/month "actual premium" how much goes to the custodial parent's health insurance coverage.  In the private health insurance sector, there is usually a contribution by the employer so the employee sees the "actual premium" for the family plan of $1000/month and the single coverage of $300/month so the cost of covering the children is $1000 - $300 or $700-the "actual premium" for covering the children.  When I use the current calculators for the exchanges, most often the custodial parent's "actual premium" only for the custodial parent is higher than the "actual premium" for the family.  In this example, it might be single coverage "actual premium" of $250/month and family coverage "actual premium" of $200/month.  SO THE SINGLE COVERAGE IS MORE EXPENSIVE THAN THE FAMILY COVERAGE.  Should the Guidelines thus not give the custodial parent any increase in child support? That parent is paying $200/month to cover the children.  But why should the noncustodial parent subsidy the custodial parent's single coverage?

The second Guidelines problem is that the "actual premium" cost is nothing but a guess.  At the end of each tax year, the parent with the health insurance coverage has to recalculate the subsidy.  In this example, first the custodial parent's "health insurance income" is lower than first assumed on the application and so there should have been a higher subsidy.  In effect, the "actual premium" should have been $150/month rather than the $200/month paid.  The custodial parent gets a check in the mail from Uncle Sam for $50 * 12 or $600.

Second the custodial parent's "health insurance income" is higher than first assumed on the application so the subsidy was too high.  If effect, the "actual premium" should have been $240/month rather than the $200/month paid.  The custodial parent rights a check to Uncle Sam for $40 * 12 or $480.

So it is possible to "game" the system.  I am the custodial parent and I put my "health insurance income" high so I get less subsidy and thus a higher premium and thus higher child support and at the end of the tax year, I get a bigger refund from Uncle Sam and I "forget" to tell the  noncustodial parent about this.  The Guidelines need to create a time machine on April 15, 2015 to go back to January 1, 2014 and recalculate the cost of covering the child with health insurance for all of 2014, run that new number through a child support calculation, multiply the monthly difference by 12, and one of the parents will pay the other this difference.  Remember that the difference in the health insurance premium must go through some percentage multiplier.  There is nothing new about this "gaming" for it is unusual for the custodial parent to inform the noncustodial parent about a reduction in child care costs and thus a child support reduction.

The third Guidelines problem is what happens when the noncustodial parent is ordered/agrees to have health insurance coverage, the custodial parent keeps the dependency exemption, and the noncustodial parent fails to keep coverage so the custodial parent has to pay the penalty.

What if the custodial parent is ordered/agrees to have health insurance coverage, the custodial parent transfers the dependency exemption, and the custodial parent fails to keep coverage so the noncustodial parent has to pay the penalty.

In either of these cases, there is the problem of adjusting any health insurance premium out of the child support and correcting any allocation of the dependency exemptions.  Should the Guidelines have language addressing child support modifications if one parent fails to maintain health insurance?

A final personal aside on this matter.  I am a sole proprietor now on Medicare and when I had a family (my wife died in 2013 and my children are all over 26), I always had good health insurance for my family and staff.  I will admit that sometimes I cast blame on teenagers for dropping out of school and other bad personal decisions but the failure of parents to have health insurance is not the choice of the child.  Based on my clients' experience with Medicaid and CHIP, those systems provide good health care for the children.  In my personal opinion, failure to maintain a child's health insurance is child abuse and criminal penalties are appropriate.
djmlaw

The information I've found in this post has been most helpful to me because my case will probably involve some of these changes.  Actually many of the posts I've read on this site are so detailed that this is the first site I visit when I have questions.  I've read some of bmull's documents and it's pretty apparent he knows quite a bit about child support.  And of course djmlaw is a family law lawyer, so the information he provided is just awesome!  I hope the child support guidelines get changed before my case goes to court.

I haven't represented myself before, but I will say @KTM that I've had quite a few attorneys over the years and I don't think any of them knew all the details about child support that bmull and djmlaw obviously do.  I don't think everyone should represent themselves because there's a lot to know, but I'm just saying hiring an attorney doesn't necessarily mean they will know more than the people on this website about child support.  It's a pretty specialized topic which requires a lot of knowledge.

Also, I've used the child support calculator from this site, the free one.  I found it to be very helpful to just understand how much money we're talking about.  Sometimes I wasn't sure if it would be $200 or $1200.  My attorney wanted quite a bit just to plug in the numbers and calculate child support for me.  I'm grateful there is at least a free tool to tell me what I can expect.