SCOTUS Decision: Coverage Expansion, Patient Protections Move Forward

The Supreme Court decision to uphold the major pieces of the Affordable Care Act (ACA) means that current patient protections on insurance coverage will stand and changes expanding coverage in 2014 will continue to move forward. Politics aside, this is good news for children and families.

Even today there are nearly 50 million uninsured Americans, and 5 to 6 million are children. Beginning in 2014, the ACA will help to improve access to comprehensive coverage of vital health services for both children and adults nationwide. Estimates are that 30 million Americans will gain coverage. In fact, some states have already expanded coverage options for children under an optional program.

Importantly, health coverage offered under the ACA will be required to be comprehensive and include many of the new patient protections already in effect. These protections include the option for families to keep children on their coverage through age 26; prohibitions on lifetime coverage limits; protection against coverage rescissions; and the elimination of preexisting condition exclusions for children. In 2014, the pre-existing condition exclusion will extend to adults and annual limits on health coverage will be eliminated.

The ACA also places a renewed emphasis on prevention, requiring coverage of many preventive services without cost-sharing. This means that vaccines and other services recommended by the American Academy of Pediatrics – including critically important developmental and behavioral screenings – will be covered and free of co-pays. By removing financial obstacles to needed preventive care and interventions, the ACA presents an enormous opportunity to improve health outcomes.

For more information on the changes that the ACA makes to our health care system, please see the policy section of our website. Fact sheets, white papers and case studies on adolescent mental health and health reform are also available.

While the debate over the best way to ensure that Americans have access to health services will doubtless continue, it is important to recognize that today’s ruling will benefit millions of children by giving them a better chance at a healthy start in life.

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