For months, California families have been living amidst anxiety and uncertainty. They are worried about their health and access to health care. And to make anxieties worse, last week the Supreme Court heard oral arguments in a case that could gut the Affordable Care Act. The decision has the potential to have monumental and sweeping impacts on the health care of millions of children and families across our state and country.
How can anyone think about taking away health coverage and critical consumer protections at all, let alone during a pandemic? Children’s health and wellbeing determines the health and wellbeing of our nation’s future. Over the last 10 years, we have made tremendous gains in California and across the country. Now is not the time to go backward.
California fully embraced the coverage provisions of the ACA that allowed it to expand Medicaid and create Covered California, our state’s health insurance marketplace. As a result, California’s uninsured rate fell a whopping 53 percent between 2010 and 2015, resulting in 3.8 million Californians gaining coverage. This is health equity in action.
Together, Medi-Cal and Covered California cover 1 in 5 Californians who are Black, Indigenous or people of color. Across the country, the case before the court threatens to take away health coverage from 21 million Americans, including 352,000 children in California. More than 3 out of 5 of these children are part of a family of color.
The ACA also had a “welcome mat” effect. When more parents got access to health coverage, more children were covered, too. More than 700,000 low-income children nationwide who had been eligible for Medicaid or Children’s Health Insurance Program (CHIP) coverage, but not enrolled, gained coverage this way.
It’s not just coverage that is at stake. Critical protections are on the line.
One of the most important provisions of the ACA is protections for people with preexisting conditions.Because of the law, children with preexisting conditions, such as asthma, juvenile diabetes, cystic fibrosis and other chronic diseases are no longer discriminated against and denied coverage. It is estimated that 17 million children — roughly 25 percent of children in this country — would be at risk of being denied coverage based on preexisting conditions.
In addition, before the ACA, health insurance companies could limit the total amount of care someone could claim against their coverage. These lifetime and annual dollar limits could easily be exhausted by a newborn in the neonatal care unit. The law abolished annual and lifetime limits and parents no longer have to live in fear of a medical emergency bankrupting their family.
Finally, for our youngest Californians, the legislation made it easier for children to access important preventive services, such as well-child visits, immunizations and developmental screenings by requiring most health plans to cover the services at no cost. Pediatric dental and vision care is part of the law’s “essential benefits.”
The ACA prioritized prenatal and early childhood care by establishing a home visiting program for pregnant mothers and those with young children in order to help them succeed. The Maternal, Infant and Early Childhood Home Visiting Programs provide instruction and care to parents on a wide range of topics, including preventive health, prenatal practices, child development and positive parenting.
During this COVID-19 pandemic, the ACA coverage and protections are more important than ever for families. This crisis has made clearer the importance of health care. Improving health equity was, and continues to be, a central goal of the legislation. We need to continue to move forward in helping families and children. We can’t abandon them in their time of need.
Kristen Golden Testa is the director of policy at The Children’s Partnership.
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