According to the two articles published in the December issue of Health Affairs, there are still millions of U.S. children that lack quality health coverage or are having trouble in getting the services they need in order for them to stay healthy or to develop properly as they age. Although the state has already promised the citizens of the United States with their health reform bill, or Obamacare, there are still a lot of development and improvement to do. According to the authors of the said issue, in order to address these gaps in the health coverage, broad reforms aimed at improving the quality of coverage for all children are needed.
The first article, written by Sara Rosenbaum, JD, and Genevieve Kenney, PhD, says that they should focus more on the future of health insurance coverage for U.S. children. They also stated that the Affordable Care Act builds on earlier advances under Medicaid and the Children’s Health Insurance Program. However, there are still challenges in making the ACA’s private insurance reform, especially for children. These challenges include: the “family glitch”, which bars subsidized Exchange coverage for children whose parents have employer coverage that is affordable only for themselves; strengthening the coverage and cost-sharing standards that health insurance plans sold in the individual and small group markets must meet.
The second article, which Rosenbaum co-authored together with her colleagues at the Children’s National Health System in Washington and Johns Hopkins Bayview Medical Center, focuses on the ACA’s essential health benefit coverage standard, which, as implemented for children, has resulted in a state-by-state patchwork of coverage for children and adolescents that contain significant exclusions, particularly for children with developmental disabilities and other special health care needs.
The study finds that the essential health benefit is standard, as implemented, fails to ensure that pediatric coverage reflects the health and developmental needs of children and that states show substantial variation in the quality of coverage they guarantee.