A Healthy Start: Protecting Great Gains for Children in the Affordable Care Act

By Marian Wright Edelman
President, Children’s Defense Fund

Since our founding almost forty years ago, the Children’s Defense Fund has fought to ensure that all children in America receive the healthy start they need and deserve. Next week marks the second anniversary of the Affordable Care Act (ACA), the federal health reform legislation, which has been a giant national step forward in reaching that goal. Although not yet fully implemented, millions of children have already benefited and millions more will be helped as additional benefits take effect in 2014. But these gains and a number of Medicaid protections that millions of Americans rely on could all be erased by challenges to the ACA and Medicaid in the U.S. Supreme Court this month. Some health reform opponents seek to undo decades of progress which would have far-reaching impact on children and an especially devastating impact on children of color.

The ACA protects and strengthens Medicaid and the Children’s Health Insurance Program (CHIP), which have been lifelines to millions of children and their families especially in the current recession. In the last year more than 1.5 million children gained health coverage through Medicaid and CHIP, bringing the number of uninsured children in America — still far too high — to the lowest on record even before many of the benefits of the new law kick in. Under the ACA, Medicaid will see the largest expansion in 2014 since its creation in 1965, and Americans with incomes below 133 percent of the federal poverty level will be eligible for Medicaid coverage. This is crucial because before the ACA’s enactment, Medicaid wasn’t a guaranteed safety net available for everyone who fell on really hard times.

The ACA is especially important for children of color, soon to be the majority of children in America, who constitute more than half of all children enrolled in Medicaid and CHIP. Right now, shocking health disparities for poor children of color begin in infancy: Black babies are more than twice as likely as white babies to die before their first birthday and the black infant mortality rate in 2006 was about the same as the white infant mortality rate thirty years ago. One in six Hispanic children and one in eight Black children remain uninsured compared to one in 14 white children. Hispanic children are 76 percent more likely and black children are 50 percent more likely than white children to have an unmet medical need due to cost, and black and Hispanic children are almost three times as likely as white children to be in poor or only fair health. The fully implemented health reform law will help close these life and death gaps and must be preserved.

The ACA doesn’t only help the uninsured, but also already insured children and families have benefited. For example, private insurers are prohibited from taking away coverage when people get sick and refusing to cover children with pre-existing conditions. An estimated four to 17 million children under 18 have some type of pre-existing condition and up to two million were estimated to have been uninsured before the new law. And insurers can no longer place lifetime caps on coverage for sick children—a huge help for the millions of children with disabilities and chronic illnesses and their families.

Preventive health services like the multiple well-child visits children need to get immunizations and screens for developmental progress are now completely free for those covered and more than14 million children have already benefited. Two and a half million young adults through age 26 have gained health coverage through their parents’ insurance policy — a huge help for college students and young adults getting started on their own in this tough economic climate.

With full implementation of the ACA in 2014, more than 95 percent of all children in America will have access to health coverage. But as we celebrate this enormous progress, we must raise our voices to protect it as several key pillars of the law are being challenged in the U.S. Supreme Court this month. These challenges threaten the ACA and could jeopardize the entire Medicaid program and have far-reaching effects on other legislation including civil rights statutes forbidding discrimination on the basis of race, gender, and disability and important federal programs that offer core protections and services for poor children, those in foster care and others.

A Supreme Court decision which undermines Medicaid’s foundation would place our military security at risk again. A 1964 government report, “One Third of a Nation: A Report on Young Men Found Unqualified for Military Service,” found an alarming 50 percent rejection rate among young men drafted into the military in 1962. Many of them were disqualified for physical and mental conditions that could have been effectively treated in childhood. Those findings helped spur Medicaid’s creation with its comprehensive benefits for children. Nearly fifty years later, Medicaid is a vital safety net, strengthened by the new health reform law to provide a stronger web of support and protection for children and families.

Now is the moment to add your voice in celebration and support of the Affordable Care Act and fight back attempts to weaken it. Together we must speak out against efforts to turn back the clock of progress. I hope the U.S. Supreme Court will seize the opportunity to affirm the Affordable Care Act and that Congress will continue to defeat efforts to block grant Medicaid and CHIP that would allow states to roll back eligibility and benefits for children and families who need them to survive and thrive. Every child needs a healthy start in life and our rich nation is long overdue in helping assure it.

 

Follow Marian Wright Edelman on Twitter: www.twitter.com/ChildDefender

The Children’s Defense Fund is an Atlantic grantee.