When the Supreme Court hears arguments starting March 26 on two major parts of health-care reform (aka the Affordable Care Act), experts say, the legal debate will ultimately affect the health of millions of children. Child-health advocates say the fate of two controversial aspects of this highly controversial law --  the “individual mandate” health insurance requirement and “Medicaid expansion,” making states cover low-income women and men even if they have kids or a disability – could change health insurance coverage for kids with preexisting conditions and kids whose families teeter on the borderline of poverty.

A new Huffington Post blog from Ann O’Leary, director, Children and Families Program at the Center for the Next Generation and lecturer at the Berkeley School of Law spells out the risks. O’Leary warns that killing off the individual mandate could threaten an ACA rule that forbids health insurers from denying coverage to kids with pre-existing conditions. That alone could affect one in four kids, who have medical issues ranging from asthma and diabetes to obesity, ADHD and autism.

Reversing expanded Medicaid coverage could toss out some of the nation’s one in three American kids covered by the program – and could jeopardize on-going health coverage for kids whose families qualify for Medicaid some years, and earn a little too much in other years. In Pennsylvania, where 5 percent of kids have no health insurance according to the nonprofit group Pennsylvania Partnerships for Children, health-care reform could help those kids finally qualify for coverage.
But that’s not all. It’s not clear what will happen to other kid-friendly benefits of health-care reform that are already in place, such as:
  • Insurance for young adults. Keeping kids on a parent's health-insurance policy until they're 26 years old – a benefit that about 2.5 million young people are now using. (Before, most kids got kicked off at age 18.)
  • A bigger menu of preventive care services. Kids covered under new health plans are eligible for many wellness tests and services without extra charges – including vision screenings, vaccines, hearing tests, fluoride supplements (if your tap water is un-fluoridated), and much more. And under the ACA, pregnancy and newborn care as well as dental and vision coverage would be covered in new plans starting in 2014.
  • No limit on lifetime care.  More than 1 million Pennsylvania kids are benefiting in one way or another from the reform law's removal of lifetime limits on care, according to Pennsylvania Partnerships for Children. 
What do you think? Has health-care reform helped your kids already? Should it continue? Let us know.