Juvenile Law Center

The historic legal arguments for and against the Patient Protection and Affordable Care Act (ACA) have concluded. The future of the ACA now rests in the hands of the United States Supreme Court. Tragically, the legal and political wrangling over the Act's provisions has largely obscured the desperately needed benefits the Act provides to millions of American children. This is hardly surprising. With no political access of their own, children are the least likely among us to hear the echo of their voices in our country's legislative chambers.

Whatever the outcome, the Affordable Care Act unquestionably has taken a bold step in taking seriously the medical needs and interests of America's children.

The Act, in particular, helps youth transitioning to adulthood access insurance, allowing them to stay on their parents' health care plan until age 26 and mandating that children aging out of foster care be covered by Medicaid until age 26. While young adults are particularly at risk of lacking health insurance, youth aging out of foster care disproportionately suffer from chronic health problems, making affordable access to continued and appropriate care central to their well-being and success.

Older foster youth who will be adopted—as states implement the Fostering Connections to Success and Increasing Adoptions Act of 2008—will also benefit by being able to remain on their parents' plans until age 26. 

Of course, the ACA not only benefits foster youth. It provides a much-needed safety net for millions of children in this country. Children who lack health care are at much greater risk of entering the child protection system and becoming wards of the state. Indeed, we cannot have a healthy social and fiscal future for this country without healthy children. 

As debate about the pros and cons of this law continues over the next several months, here are some facts about the ACA that should have a prominent place in any discussion in which the present and future welfare of our children is part of the conversation:

1. According to a study by the Children's Defense Fund, in 2009 there were nearly 8 million children in this country without health insurance.
2. The ACA addresses the insurance market's failure to provide affordable and appropriate health care for especially vulnerable populations such as children. 
3. Unlike adults, children can neither purchase health insurance for themselves nor control their access to health care. Failure to provide appropriate care in childhood can have significant long-term impacts for children—permanently affecting their physical well-being, educational outcomes, and productivity. 
4. About half of children with special health care needs lack access to comprehensive health care. This is largely because of the increased cost in insurance policies, restrictions of the coverage of pre-existing conditions, and maximum caps or other limitations on coverage. The ACA eliminates these barriers.

The ACA also protects children's health by:

• Requiring insurance providers to provide evidence-based preventative care and screenings, including immunizations, screenings for hereditary diseases, and other preventative care;
• Providing for innovative programs to deliver health care to children in their own homes and in schools, greatly improving outcomes and reducing long-term costs associated with poor outcomes. 

The value of these critical benefits should not be lost in the din of the political battle that rages around the ACA. While much opposition to the ACA has been couched in the rhetoric of individual freedom, freedom is meaningless for children who have been raised by the state, and then cut loose to fend for themselves. 

Related Litigation

Department of Health and Human Services v. State of Florida: Juvenile Law Center signed on to an amicus brief written by Child Rights Project at Emory University School of Law and Bondurant, Mixson & Elmore, LLP on behalf of child advocacy organizations in support of petitioners on the minimum coverage provision question. 

The brief addresses the constitutionality of the provisions of the federal Patient Protections and Affordable Care Act (ACA) that relate to health insurance for children and youth transitioning to adulthood.