by Wendy Lazarus
In the year since President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law on March 23, 2010, a sea of ink and digital bits have been spilled on every possible angle of commentary and advocacy about the law. But a year later, one simple conclusion deserves its share of sunshine: Health Reform is good for America’s 74 million children.
The Good News:
Insurance companies are no longer able to deny any child health coverage for chronic conditions. Common conditions such as asthma or diabetes were previously excuses for refusing coverage, even though these are the conditions that most often require health care for children. These diagnoses are grim enough to receive anyway. You can imagine the relief, now, for families who no longer have to fear whether they can get basic health insurance for their child. In California, alone, 1.1 million children and youth under age 25 have pre-existing conditions that previously would have resulted in health coverage denials.
Take, for example, this story from Celina, a MomsRising member from California. Her story demonstrates why moving forward with health care reform is critical for ensuring all kids have the chance to grow up healthy:
My child is adopted and was born with reflux and was later diagnosed with asthma. I cannot imagine what I would have done if his health was further compromised, because health insurance was denied due to a pre-existing condition. Thanks to our ability to secure ongoing health check-ups and keep his asthma under control, we have never experienced a full flare up nor have had to visit the emergency room. Which translates to many dollars saved!
Another relief to many families is that young adults can stay on their parent’s insurance through the age of 26. With a struggling economy, this option can be essential for young adults who are just getting started, and especially for those for whom a gap in health coverage would be life-threatening. Here’s an example from our colleagues at Young Invincibles: Sara, a 22-year-old with Type I Diabetes. After she began working a part-time job, she no longer qualified for Medicaid, and, without insurance, she would have to pay over $850 a month to control her condition. Her options are woefully limited without health reform.
When Sara found out about the cancellation of her health insurance, she tried to purchase insurance from her college campus, San Diego State University. However, after speaking with the school social worker, she found out that the plan would not work for her. It would only cover a maximum of $500 a year for over-the-counter prescriptions, nowhere near enough to meet her needs.
Looking to the private market has also not been an option. Although she works part-time while in school to help pay the rent, she does not earn nearly enough to pay the premium of a private market plan. As a result, Sara has stayed uninsured,
cobbling together various ways to maintain her health.
And it’s not just these individual stories that show how the law is making a difference. After the first year, the impact of the expanded coverage can be seen in a rise in enrollment. In California alone, Health Access estimates the number of newly eligible enrollees to be 200,000. And the California Public Employee Retirement System (CalPERS) reports to have enrolled 28,000 new older children.
For children and young people, especially, the focus needs to be on wellness and prevention-and it is under the Affordable Care Act. The good news is that families cannot be required to pay co-payments for preventive screenings, a provision that will protect nearly 6 million children under age 19 in California alone. By ensuring that children receive the right vaccinations and diagnoses, more expensive health care costs down the road can be avoided. More good news: insurance companies can’t just drop children when they are sick or limit the lifetime value of coverage.
And, families will finally have more control over their own lives. Without being restricted to employer-based coverage, if a child has a condition that would have been previously denied, a parent can make employment decisions that are in the best interest of their family, without risking their child’s coverage.
The Challenge Ahead:
If we are to reach our goal of making sure all of America’s 74 million children are insured by 2014, we cannot sit back now and jeopardize these tremendous gains. We must encourage political leaders to ensure that federal funding and guidance are available for full and effective implementation of ACA.
Making health reform work for families depends on states taking thoughtful and swift action, too. At this time when states across the country are struggling with serious budget deficits, we urge elected officials along with employers and philanthropic leaders to support states as they leverage the available federal funding for implementation as soon as possible.
As debate about the law continues in Congress and in the courts, we must remind ourselves that quality healthcare is good for our kids-and every child should have the opportunity to grow up healthy.
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.