What’s next for children with special health care needs?


In a 5-4 decision, the U.S. Supreme court upheld the constitutionality of President Obama’s healthcare reform law, the Affordable Care Act.
Several outcomes from the ruling include:
The provisions that have already been implemented, including prohibiting pre-existing condition exclusions for children under age 18 and allowing adult children to stay covered under their parent’s health insurance until they turn 26, remain in effect.
Those provisions scheduled to roll out over time will proceed as planned, with the exception of the Medicaid expansion.
The Court also ruled that states could not be compelled to participate at the risk of losing all federal funding for their Medicaid program. The expansion is now optional.
The Catalyst Center has identified three essential components of the ACA ruling that will impact children with special health care needs:

  • Universal and Continuous Coverage – The ACA offers a safety net of consumer protections including: prohibiting  pre-existing condition exclusions – a ban on coverage rescission – offering young adults who are aging out of foster care the opportunity to retain their Medicaid coverage until age 26 – simplified eligibility and enrollment processes for Medicaid and Children’s Health Insurance Program (CHIP) coverage.
  • Adequate Coverage – The ACA has several provisions related to adequacy of coverage, including: the removal of annual and lifetime benefits caps – health homes for Medicaid-enrolled children with chronic conditions – a comprehensive list of “essential health benefits” that will be required in the individual, small group and Exchange plans.
  • Affordable Coverage – Under the ACA, the plans offered through the State Health Exchanges scheduled to open in 2014, will include premium tax credits and cost-sharing subsidies.

Read more about the ACA and it’s impact upon the face of medical care for children with special health care needs at The Catalyst Center, The U.S. Supreme Court Ruling on the Affordable Care Act.
Articles at The White House Blog and The New York Times, Supreme Court Upholds Health Care Law have additional information about the overall impact of the Supreme Court ruling on the ACA.

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