On September 23, 2010, a potentially life-saving, but surprisingly overlooked change will occur for the families of America’s 74 million children.  That is the day when U. S. children become eligible for the first phase of benefits as our nation implements the Patient Protection and Affordable Care Act, a law that will eventually extend health insurance to all Americans. California’s 9.4

The importance of this historic milestone for children – 9.4 million living in California – has been crowded out by September’s back-to-school rituals, football games, and a focus on the November elections.  But the reality that every U.S. child can now have affordable health insurance is a sea change in this country. Until now, tens of thousands of parents kept their children from playing high school sports because they couldn’t pay for insurance and feared an expensive injury.  Until now, a child with a heart problem or a common childhood condition like asthma or diabetes would be denied health insurance by health plans. Until now, too many parents have had to decline better job opportunities so they could keep the health coverage that enables their child to function in school or, in cases like childhood cancer, even stay alive. Until now, these realities have also made family medical crises one of the most common causes of bankruptcy in this country.  

On this day, September 23, the most important health care breakthrough for children in a generation begins.

Starting September 23, insurance companies can no longer deny coverage to a child without health insurance because he or she has a pre-existing health condition.  Starting that day, young adults can begin signing up to stay on their parent’s insurance until age 26.  Starting that day, insurance companies will be required to cover preventive care, including immunizations, at no cost to the family, and insurance companies won’t be able to drop children when they are sick, or limit the lifetime value of coverage.  Finally, families will be able to use a Web site (healthcare.gov or cuidadodesalud.gov) or call a toll-free number (1-877-KIDS-NOW) to learn about health coverage options available to them-whether it is a publicly subsidized program like the Children’s Health Insurance Program (Healthy Families in California), Medicaid, employer coverage, a state’s High Risk Pool, or, after January 1, 2014, the state’s health insurance “marketplace” called the Exchange.

Children, of course, are only one of many groups of Americans previously unable to secure basic coverage who will be able to get it.  Come January 1, 2014, their parents, aunts, and uncles will all have a place to go for insurance.  And while some reforms for these populations also take effect on September 23, children can disproportionately benefit now for three reasons.  First, certain reforms like prohibiting insurance companies from excluding a person from coverage because of a pre-existing condition begin with children. Second, the vast majority of children who go without insurance today (65%) qualify for an existing program and simply need to enroll.  This is our opportunity to make sure all of their parents know this and take the steps to get them covered. Third, proper health care for children means a longer, healthier life.

After decades of working to achieve this monumental improvement, we must now make sure the Affordable Care Act works well for families, and that starts immediately with children.  Step 1 is to shout this news from every pulpit, school, workplace, recreation facility, and anywhere else we can reach parents-and to help parents enroll in the coverage their kids qualify for right now.  At least 5 million children will be able to get basic health care as a result.  Step 2 is we must hold our elected leaders personally accountable for making these historic reforms work.  Whether Congress looks somewhat similar or very different after the November elections, or whether Jerry Brown or Meg Whitman becomes California’s next Governor, the test of their leadership is straightforward: ensuring all of our children have health insurance.

Here’s how to do the math: 7.3 million children (10% of kids) are uninsured today-with that number growing every day in this difficult job market.  They all need the benefits of the Affordable Care Act.  Through smart implementation decisions and necessary investments, we can cut that number by 2/3 in five years and meet the challenge set by U.S. Health and Human Services Secretary Sebelius: to enroll 5 million uninsured children in five years.  And we can deliver to these millions of children their birthright to grow up healthy and lead productive lives.  Moreover, by doing so, we can save taxpayers millions of dollars in cost savings realized by preventive and targeted health care to kids.  Of course not the least of the benefits will be the tremendous pride we can collectively share in having done the right thing for the youngest among us-perhaps the most worthy goal of all.

Wendy Lazarus

Is the Founder and Co-President of The Children’s Partnership, which advocates for improvements in child health care. Ms. Lazarus has been involved in advocacy for health coverage for all children for more than 35 years.