THE SUPREME COURT UPHELD THE ACA (YET AGAIN!)
WHAT IT MEANS FOR CHILDREN WITH SPECIAL HEALTHCARE NEEDS AND THEIR FAMILIES
BY LAUREN AGORATUS, M.A.
WHAT WAS THE CASE ABOUT?
In some states, challengers to the Affordable Care Act (ACA) sought to dismantle it on the basis of unconstitutionality. On June 17, 2021, the Supreme Court decided that those who challenged the ACA "had no legal standing to file their lawsuit seeking to nullify a law…"1 The Supreme Court's 7-2 decision reassured families of children with disabilities that the ACA remained the "law of the land."
REACTIONS FROM ADVOCACY GROUPS
SPAN Parent Advocacy Network issued a statement in support of the ACA. It read in part:
• Since its inception, Obamacare has provided coverage for more than 20 million Americans and saved tens of thousands of lives.
• It has protected people with pre-existing conditions from discrimination – including common medical issues like diabetes, asthma, cancer, Alzheimer's, and even pregnancy! This includes providing protections for essential health benefits, including prescription drugs, maternity care, and behavioral health.
• States receive $135 billion in funding for their healthcare marketplaces, Medicaid, and the Children's Health Insurance Program (CHIP).
• Medicaid expansion has led to better access to care and health outcomes for 12.7 million lower-income individuals and their families in 36 states.
• Healthcare has become more affordable overall.
• Women can no longer be charged more for insurance and are guaranteed coverage for services essential to women's health.
• Millions of disabled Americans have been protected from arbitrary annual or lifetime coverage limits.
SMALL BUT MIGHTY: The Supreme Court ruled 7-2 that the plaintiffs lacked standing to challenge the health care law. This was the third challenge to the ACA rejected by the Court, and a huge relief for many families.
Little Lobbyists had a blog and parent story on special needs kids and the ACA. In the blog, the first parent was concerned if they could afford the best medical treatment. The father's goal was to give his son "the best chance at a healthy, independent life… Without bankrupting our family…" He continues to state that his son had multiple hospital stays and surgeries resulting in "multimillion dollars in medical bills."
The second family story, also from a father, notes his son was born premature, spending months hospitalized. He cites that before the ACA, many insurance plans had coverage limits over a lifetime, which he would have met or even exceeded just for the first hospital stay. The ACA was passed literally days before his son's birth. The Arc national also put out a statement in support of the Supreme Court decision. In part it reads:
"The ACA is critical to the lives of people with disabilities… Without it, millions of adults and children would lose their health coverage, or it would become unaffordable, during an unprecedented time of health risk and uncertainty, as well as economic instability… This uplifting moment is about the millions of people with disabilities, their fami lies… that rely on the ACA for access to health coverage for preventative care, to maintain good health, and secure vital medical treatment. This moment is about protecting them from discrimination."
ACA PROTECTIONS FOR CHILDREN WITH DISABILITIES
In addition to the elimination of annual/lifetime "caps", other benefits include protections for pre-existing conditions. This means that a child with a certain condition can't be dropped by the insurer. Mental health and behavioral health are key components of the ACA, particularly important to parents of children with mental illness or developmental disabilities. Therapies like physical, occupational, and speech therapy are covered for children. Prior to the ACA, many insurance companies denied habilitative therapies for children (unlike rehabilitative for adults) as "developmental or educational". Wellness services, such as immunizations, are important for all children and are now free.
The recent Supreme Court decision allowed families of children with special health care needs to breathe a collective sigh of relief. These enduring protections will allow children with disabilities to continue to more easily get the medical care that they need – and their families to afford that care.•
HERE TO STAY : REACTION TO THE ACA RULING
SPAN PARENT ADVOCACY NETWORK STATEMENT spanadvocacy.org/blog-post/span-applauds-supreme-court-for-decisive-obamacare-ruling
LITTLE LOBBYISTS Blog and parent story littlelobbyists.org/blog/2021/6/22/a-reflection-on-the-healing-power-of-the-affordable-care-actnbsp-by-peter-witzler vox.com/policy-and-politics/2017/6/21/15842780/senate-health-care-lifetime-limits
NATIONAL DISABILITY NAVIGATOR RESOURCE COLLABORATIVE Child with Special Health Care Needs factsheet nationaldisabilitynavigator.org/ndnrc-materials/fact-sheets/population-specific-fact-sheet-child-with-special-health-care-needs/
TO LEARN MORE: HHS: Statement by HHS Secretary Becerra hhs.gov/about/news/2021/06/17/statement-hhs-secretary-xavier-becerra-us-supreme-court-decision/index.html
CMS: Statement by CMS Administrator Brooks-LaSure cms.gov/newsroom/press-releases/statement-centers-medicare-medicaid-administrator-chiquita-brooks-lasure-us-supreme-court-decision Community Catalyst: Press Release communitycatalyst.org/news/press-releases/supreme-court-upholds-aca-preserving-care-for-millions
Georgetown University Center on Health Insurance Reforms: A Great Day for the Affordable Care Act chirblog.org/a-great-day-for-the-affordable-care-act Health Affairs: Supreme Court Rejects ACA Challenge; Law Remains Fully Intact healthaffairs.org/do/10.1377/hblog20210617.665248/full
ABOUT THE AUTHOR:
Lauren Agoratus, M.A. is a parent of a medically-complex young adult and serves as the Coordinator for Family Voices-NJ and as the regional coordinator in her state's Family-to-Family Health Information Center, both housed at SPAN Parent Advocacy Network (SPAN) at spanadvocacy.org