The new health care reform legislation, signed into law by President Obama is sure to be discussed at next Thursday’s Urban Child Symposium; in the meantime, here’s a short overview of the law’s major effects on children and families:
- Insurance companies will be prohibited from denying health coverage to children with pre-existing conditions. For example, children suffering from asthma who don’t have insurance coverage will now be able to get coverage.
- CHIP (Children’s Health Insurance Program), which provides public health care to lower-income children, will be expanded to reach more families (up to 133% of the federal poverty line) and protections will be in place to prevent CHIP reductions in the near future.
- Beginning in 2014, people who make up to 400% of the federal poverty line will be eligible for government subsidies for health care they purchase, with the amount based on their income.
- The law authorizes new programs for preventive health, including School-Based Health Clinics, oral health education, and substance use disorder and mental health problem prevention.
- Co-pays for many preventive services, like immunizations, will be eliminated from most health plans.
Medicaid will cover an annual well-visit, assistance for pregnant women to quit smoking, and other preventive services. - Young adult dependents will be eligible for coverage on their parents’ plan through age 26.
- Beginning in 2014, families who currently do not get employer-provided health care coverage will be able to purchase health care at a reasonable price from state-run “exchanges” (insurance marketplaces with built-in consumer protections designed to pool risk and provide affordable individual or small group policies).
- Individual, small group, and new Medicaid health plans will be required to include substance use disorder and mental health services in their basic packages and to treat these benefits the same as all others.
We’d like to hear from you–on this blog and at next week’s conference. Does the law do enough? Does it do too much? Which health problems will the new law address and which are not addressed? What role will the law play in the day-to-day health issues of urban children? How can new funding best be used to tackle the most pressing problems? How should legislators prioritize the different health challenges that exist in urban environments? How can advocates and citizens ensure that legislators prioritize correctly? What else can be done to address urban child health issu
What still needs to be considered is the specifics of CHIP. Though great in concept, and CHIP expansion is an excellent idea in the dawn of the need for preventative rather than prescriptive measures, states need to consider a uniform set of policies and terms across state borders. Those who move across state lines often (possibly due to economic necessity) will find their children covered for some procedures and services in one state, and not covered for the same services and procedures down the road in a different state. For children with chronic health issues this poses an especially difficult problem to overcome. Now, this new legislation may address this issue, in which case I stand corrected and applaud such a provision. But expansion of the program doesn't address inconsistent coverage. In my view, more uniform implementation of CHIP would be an excellent aspect to consider in the future.
This is a huge first step. Health care coverage is vital to keeping individuals from becoming poor (given the huge medical costs and debts that can be incurred) and to lifting individuals out of poverty. For those of us interested in equity for youth especially youth involved in the justice system the law does not go far enough for some youth who are incarcerated or have been incarcerated. The prohibition against the use of Medicaid for these youth and the lack of aggressive efforts to re-enroll Medicaid eligible youth upon release must be addressed. I hope that this issue will be among the many next steps and fixes that we see.