Five weeks remain until adults can sign up for health plans through online marketplaces, but many parents don’t know that some services mandated through health care reform are already available to children. U.S. News held a Twitter chat with experts from the Urban Institute, Georgetown University’s Center for Children and Families, First Focus and the American Academy of Pediatrics last week to address the broad impact of Obamacare on children’s coverage. They discussed open enrollment, the statistics of uninsured children, public versus private insurance, additional pediatric benefits and changes for young adults.
Shopping for health insurance
Under Obamacare, individuals and families that lack government or employer-based health plans — including self-employed people and those working for companies with fewer than 50 employees — will be eligible to shop for coverage in marketplaces called Health Insurance Exchanges. This collection of online insurance shopping malls is scheduled to open Oct. 1. It will feature websites established by the federal and state governments. U.S. News will offer a guide to the state exchanges, along with individual health plan data at U.S. News Best Health Insurance Plans. Families also can go directly to a broker or health insurance company. An estimated "11.5 million parents are uninsured," tweeted the Center on Children and Families during the chat. "Many will have coverage for the first time in January," when the insurance kicks in.
Children don't have to wait. Most are already eligible for coverage today. Stephen Zuckerman, senior fellow for the Urban Institute wrote that this coverage comes through Medicaid and the Children's Health Insurance Program (CHIP). Joan Alker, president of the Center for Children and Families, called Medicaid and CHIP, free or low-cost health coverage run by the federal and state governments, the "MVPs" of health insurance for children. "It brought uninsured rate for kids to record lows ... in 2011," she tweeted.
How many kids are uninsured?
The rates of uninsured children are at a record low. Still, one in 10 — or 7.6 million — children in the United States is uninsured, according to the Children's Defense Fund, a child advocacy nonprofit. Parents often aren't aware that children are eligible to sign up for benefits through public plans, says Bruce Lesley, president of First Focus, a bipartisan advocacy organization for children and families. "Many kids will get insurance just because of news about the Affordable Care Act," he wrote. Zuckerman tweeted, "research shows that when parents get covered, children benefit too."
Should parents consider public and private insurance?
In some cases children are better off signing up for public health insurance than through private plans or through state marketplaces. To evaluate which is best, parents need to look at the cost of the plan, its benefits and the choice of doctor. Lesley wrote that "parents should be looking for a robust network of pediatric providers." Thomas McInerny, president of the American Academy of Pediatrics, urges parents to "make sure their current pediatrician is included in the plan they choose so kids can stay within their medical home." Lisa Clemans-Cope, senior research associate for the Urban Institute, wrote, "Compare CHIP benefits, cost sharing and network, because the employer coverage may give better access." Cost sharing covers deductibles, copays and other health plan provisions that shift costs to consumers.
What benefits should parents expect for children?
Private health insurance plans now offer many of the same services as Medicaid and CHIP in some states. Twenty-six preventive services are now free to families with private insurance, eliminating copays, deductibles, or co-insurance. This includes immunization for Hepatitis A and B, Tetanus and HPV; obesity screening and counseling; blood pressure, autism and depression screenings and iron supplements for children ages 6 to 12 months at risk for anemia, among other measures. First Focus tweeted that covering preventive care helps "keep kids healthy and [manage] problems before they get out of hand." Children under 19 with disabilities or pre-existing conditions, like asthma, diabetes and cancer, cannot be denied coverage or dropped from a plan.