Later this week, the Supreme Court will make a momentous ruling on the constitutionality of the Affordable Care Act, the health care reform law passed in 2010. If the law is upheld, millions of children and youth will benefit. If all or part of the law is struck down, ECM believes millions of children will be harmed. Here is what could happen to coverage of children and young adults if the law is repealed:
· A Return of Pre-existing Coverage Exclusions for Children – Insurance companies could go back to denying coverage to children with pre-existing conditions, giving their families no protection if their children need extensive care.
· A Reduction in Coverage Through the Children’s Health Insurance Program – Overturning the law puts at risk federal funding for the Children’s Health Insurance Program (CHIP) that was extended through September 30, 2015 to provide states with additional funding to ensure children have access to this successful program.
· An End to the Pediatric Benefit Package that Includes Oral and Vision Coverage for All Children – The law requires coverage of not only basic pediatric services under all new health plans, but also oral and vision needs, starting in 2014. Many health plans do not provide coverage for needed child health services, and 12 percent of children have not had a doctor’s visit in the past year. This would continue if the Court overturns the law.
· An End of the Effort to Improve Quality of Care for Children – The law develops children’s quality priorities and promotes children’s quality measurement and reporting to improve care. A recent study found that children receive recommended care less than half of the time.
· A Denial of Coverage to Families without Employer-Based Care – The law provides health insurance choices through state-based health insurance Exchanges to families without job-based coverage and provides tax credits to those who can’t afford it. Expanding insurance to all children will enable them to access needed care, which is proven to enhance their development and learning, laying the foundation for a healthy life. Children who are uninsured have decreased access to well-child care, immunizations, basic dental services, and prescription medication. Overturning the law will lead to lifetime health burdens to children denied the coverage they would have received through this law.
· A Return of Lifetime Caps on Coverage – The law ends all lifetime limits on how much insurance companies cover if beneficiaries get sick, and bans insurance companies from coverage when they get sick. The Act also restricts the use of annual limits in all new plans, and existing employer plans this year, until 2014 when all annual limits for these plans are prohibited. Two-thirds of middle class families with access to employer-based coverage said their child remained uninsured because they could not afford the health plan. Overturning the law will raise health care costs for families and lead to more uninsured children.
· An End to the Extension of Coverage up to the Age of 26 – The law allows young adults to stay on their parents’ health care plan until age 26. Millions of young adults continue to have coverage as a result of this law. Overturning it could lead to insurance companies dropping them as soon as they can or to keep costs down.
If the court upholds the law, then all states must move swiftly to implement the law’s many benefits. If the court invalidates all or part of the law, Congress must act as soon as possible to preserve the health of the nation’s young people. If the law is struck down, Every Child Matters will urge the Congress to quickly pass a new law that preserves the coverage children would have received through the Affordable Care Act. Doing nothing and going back to a system that left 9 million children and young adults without coverage and threatens the millions more who receive coverage through the State Children’s Health Insurance Programs, simply is not acceptable. The Justices on the Court, the Congress, and all Administration officials have comprehensive coverage provided by the government for the rest of their lives. Every child should receive the same coverage.