Health Care Reform: The ACA and Children with Special Health Care Needs

The Patient Protection and Affordable Care Act (ACA), signed into law on March 23, 2010, offers opportunities to close gaps in coverage for children and youth with special health care needs (CYSHCN).

On June 28, 2012, the Supreme Court announced that the ACA is constitutional. At that time, we reflected on What’s next for CYSHCN To commemorate the anniversary of this decision, and as the country works towards full implementation of the ACA in January 2014, we put together a poem: The Hundred Years’ War for Health Care Reform, based on an article by A. W. Gaffney.

Below are some of the resources the Catalyst Center has developed to help stakeholders wade through the details of this complex legislation to better understand just what health care reform and the ACA may mean for CYSHCN and their families.

Family stories

To gain a better understanding of what the ACA may mean to real families, read these reflections from parents:

Beyond the Rhetoric: What the ACA Means for My Family

The Wardyga Family: Justice for Jason

	The Affordable Care Act: A Working Guide for MCH Professionals (“ACA 101”) This guide, developed by the Access to Care Core of the National MCH Workforce Development Center, provides the building blocks for current and future MCH professionals to learn the basics of the Affordable Care Act and its implications for Title V programs.
	The Affordable Care Act: A Side-by-Side Comparison of Major Provisions and their Implications for CYSHCN [PDF] This brief offers a concise description of select provisions in the Patient Protection and Affordable Care Act (ACA) with a side-by-side analysis of what they may mean for children and youth with special health care needs (CYSHCN) and their families.
	Publication: The Affordable Care Act and Children with Special Health Care Needs: An Analysis and Steps for State Policymakers [PDF, 48 pages] The Affordable Care Act (ACA) provides states with important tools to help children and youth with special health care needs (CSHCN) and their families access coverage that is universal and continuous, adequate and affordable. However, interpretation of the law and addressing implementation challenges with the unique needs of CYSHCN in mind will shape how well the ACA fulfills its promise to this vulnerable population. This paper developed by the National Academy for State Health Policy (NASHP) for the Catalyst Center reviews and analyzes key provisions of the ACA relevant for CYSHCN to help inform state policymakers’ decisions in implementing health care reform.
	Medicaid/CHIP Tutorial Section 9: What’s New Under the Affordable Care Act? [PDF, 5 pages] in Public Insurance Programs and Children with Special Health Care Needs: A Tutorial on the Basics of Medicaid and the Children’s Health Insurance Program (CHIP)(A publication by the National Academy for State Health Policy (NASHP) for the Catalyst Center, Feb. 2012) Webinar: What Changes Can I Expect from the ACA and How Do I Make the Case for Partnership in My State? (Sept. 19, 2012) This tutorial provides a user-friendly overview of Medicaid and CHIP coverage for children and youth with special health care needs (CYSHCN), specially written with Title V MCH staff and family leaders in mind. It includes information on how Title V and state Medicaid officials can work together to increase the quality and decrease the costs of health care for children with special health care needs. Section 9 focuses on Medicaid eligibility changes in the ACA in the context of the goal for health care reform: that nearly everyone will have public or private health coverage by 2014. An associated webinar covering this material was conducted on Sept. 19, 2012. The slides and recording are available.
	Webinar: Children and the Medicaid Health Home State Plan Option Section 2703 of the ACA describes a state plan option to provide health homes for Medicaid-enrolled individuals with at least two chronic conditions, one chronic condition and the risk of developing a second, or one serious and persistent mental health condition. For this webinar, AMCHP and the Catalyst Center assembled a panel of experts on medical home implementation, federal Medicaid policy and state leadership in Title V and Medicaid partnership to help answer questions and encourage planning for including CYSHCN in state adoption of Section 2703.
	Webcast: The Affordable Care Act and Children with Special Health Care Needs As a companion activity to the release of the NASHP publication described above, NASHP and the Catalyst Center hosted a joint webcast at the end of January 2011. Policy experts from the NASHP and Catalyst Center teams presented highlights from their analysis. A panel of state and federal officials shared their perspectives on the report.
	Issue Brief: The Affordable Care Act and Children and Youth with Autism Spectrum Disorder and Other Developmental Disabilities [PDF, 12 pages] The Catalyst Center has developed a new report for the Association of Maternal & Child Health Programs (AMCHP) that offers a brief description of selected provisions in the ACA that have implications for children with ASD/DD. It describes how state Title V maternal and child health (MCH) programs can maximize opportunities under the ACA to develop and strengthen systems of care for children and youth with ASD/DD.
	Your Questions About the Medicaid Expansion Provision of the Affordable Care Act Answered [PDF] One of the many ACA-related topics that we have been following closely is the Supreme Court’s decision that made the Medicaid expansion optional for states. This brief discusses the implications of the Medicaid expansion for CYSHCN and young adults with special health care needs.
	Your Questions on the Essential Health Benefits Bulletin Answered [PDF] A compilation of answers to several questions that our stakeholders have asked regarding the Essential Health Benefits Bulletin issued by the U.S. Department of Health and Human Services (HHS) on December 16, 2011, and its possible impact on CYSHCN.
	What’s the Deal with MOE? States want to cut Medicaid spending. Are CYSHCN at risk? [PDF] The March 2011 issue of Catalyst Center Coverage featured a discussion of how the Maintenance of Effort (MOE) provisions in the Affordable Care Act are viewed by some states under stress due to fiscal constraints.
	Fact Sheet: Health Care Reform: What’s in it for Children and Youth with Special Health Care Needs? [PDF] This joint fact sheet from the Catalyst Center and the Association of Maternal and Child Health Programs (AMCHP) provides an overview of how CYSHCN may benefit from selected health care reform provisions and where opportunities for maternal and child health professionals to play an active role in implementation might lie.