Since it took effect in 2010, the Affordable Care Act, has made important changes to the way health care coverage works for children and families. Starting October 1, 2013, people can compare insurance options in state marketplaces. On www.aap.org/ACAmarketplace, the AAP has developed state-specific resources for pediatricians and parents to help understand how to find a health insurance plan that meets the needs of children and families.
AAP's Priorities: the ABCs of Health Reform for Children
During the debates leading up to the law’s passage, the AAP championed three fundamental priorities for children and pediatricians, as simple as ‘A-B-C’: Access to health care services, age-appropriate Benefits in a medical home and health care Coverage for all children in the United States. The Affordable Care Act not only addresses these goals, but provides many additional benefits for children and the pediatricians who care for them.
As of September 23, 2010, the following child health reforms have already taken effect:
• guaranteed health care coverage for children with pre-existing conditions
• no more lifetime coverage limits
• restrictions on annual coverage limits
• essential preventive care services (as recommended by Bright Futures) are provided with no cost-sharing for families with new health insurance plans
• insurance companies are prevented from dropping coverage when a child or adult gets sick
• young adults can stay on their parents’ health insurance plan until they turn 26
• out-of-pocket expenses are capped at $5,950/individual and $11,900/family
• parents can designate a pediatrician as their child’s primary care provider
Health Reform Implementation
While the ACA was signed into law in 2010, many of its provisions require additional guidance before they take effect. Often, this level of detail comes from federal regulations that further define the law’s many provisions. The Academy has been at the forefront of this level of advocacy, having written numerous public comments
to ACA regulations.
The Academy will continue to provide feedback to federal agencies overseeing the law’s implementation to ensure that the ACA provides children with access to the services, coverage and benefits they need to stay healthy. The Academy is also actively working at the state level with AAP chapters to ensure that state implementation of health care reform meets the needs of children and the profession of pediatrics.