Health Reform: What Does it Mean for Children?

Why It's Important

We know that children’s health and overall well-being is linked with whether they have access to health care coverage. 

Having health coverage is a key indicator of a child’s well-being. 

Without it, a child is 20 to 30 percent more likely to go without needed immunizations, medications, and basic dental care. Uninsured children are more likely to miss school and to experience costly hospitalizations.  Too often low-income children without health coverage are forced to wait until a health problem becomes an emergency before receiving treatment.

There are more than eight million uninsured children in America or one in ten.  Health care costs for working families continue to rise, making it difficult to afford insurance or access timely care.

Our nation's health care system affects every person in the United States, insured and uninsured alike. If we are to end the problem of children growing up without health coverage and ensure affordable coverage, real health reform is necessary.  

By ensuring every child and pregnant mother access to health care coverage, we are committing to the success of our children's futures as well as making an investment into our nation's future.

The New Legislation:

Expands and strengthens the child health safety net.

• Provides the greatest expansion of Medicaid coverage for the poor since the program’s enactment in 1965.  At least 16 million children, parents and childless adults with incomes below 133 percent of poverty ($29,400 for a family of four) will be eligible for Medicaid, with its guaranteed comprehensive benefits, including 1.6 million children currently eligible for CHIP. In order for newly eligible parents to enroll in Medicaid, they must first ensure their children are covered.  (Effective 2014)

• Maintains the Children’s Health Insurance Program (CHIP) until 2019, when we will know whether the new “health insurance exchanges” are able to provide children with benefits and cost protections better than or comparable to what they have now.  CHIP is fully funded through 2015 – doubling the number of eligible children who can be served from 7 to 14 million. (Exchanges will begin operating in 2014)

• Increases Medicaid payment rates to ensure more low-income children will have access to primary care service providers who accept Medicaid patient. (In effect 2013 and 2014.)

Prevents insurance companies from unjustly denying coverage to children. 

• For children with insurance, insurers will no longer be able to refuse to cover treatment of children's pre-existing conditions.  (Effective September 23, 2010.) 

• Prohibits insurance companies from placing annual or lifetime caps on coverage and from rescinding coverage when a person becomes sick.  (Effective September 23, 2010.)

Makes health coverage more affordable for parents and children.

• For families with incomes below 400 percent of the Federal poverty level (up to about $88,000 for a family of four) that are not insured through an employer, tax credits will be available to help them purchase meaningful health coverage.  (Effective in 2014 when the exchanges are operational.)

Makes it easier for children to get health coverage and keep it. 

• Enables eligible children to remain insured, even if their parents change jobs, move or get sick.

• Establishes a “no wrong door” system in states so the entire family can get screened for and enrolled in coverage in a single stop, regardless of which program they are eligible for. (Effective in 2014 when the exchanges are operational.)

• Parents will be allowed to keep their children on their insurance until age 26.  (Effective September 23, 2010.)

• Provides new investments in prevention.

• All “Bright Futures” services – the standard of pediatric well-child and preventive coverage recommended by the American Academy of Pediatrics – will be covered for children starting this year with no co-payment in all public and private insurance.

• Establishes a new home visiting grant program to provide voluntary quality evidence-based home visiting services to young at-risk children and their families to improve maternal and newborn health, promote healthy child development, strengthen parenting skills, enhance school readiness and prevent child maltreatment. ($100 million in grants available for FY 2010.)

Improves the reach and delivery of services. 

• Increases funding for community health centers to improve access and delivery of care for millions of children and families across the country. ($11 billion available for FY 2011.)

• Allocates funding to strengthen School Based Health Centers (SBHCs) that currently provide comprehensive health coverage and other services critical to child and youth development to more than one million children across the country.  ($200 million over four years beginning FY 2011).

Includes extra assistance for the most vulnerable children. 

• Requires states to extend Medicaid coverage to age 26 for youths who were in foster care at age 18 or older who are not otherwise eligible for Medicaid. (Effective 2014.)

• Requires states to include information about the importance of having a health care power of attorney for children and youths in foster care in their independent living programs and in the transition plans for youths aging out of foster care.  (Effective October 1, 2010.)

• Extends the adoption tax credit to December 31, 2011, makes refundable for all types of adoption for tax years 2010 and 2011, and increased the amount of the credit for 2011 to $13,170.