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Yeah -- no copay for well child visits!

By Elisabeth Burak, Georgetown University Center for Children and Families

As some Say Ahhh! readers know, I recently moved across the country with my husband and toddler.  It's been more than three months, but we're still searching our new place for clothes or items that got lost in the shuffle.

Of course, part of moving is also setting up your life in a new place --new bank accounts, health insurance plans, and, of course, doctors and other health care providers.  I did my due diligence in January and took my daughter Maddie to her 15-month appointment with a new pediatrician. When we were finished--with child care immunization forms in hand!--I headed to the front to check out and pay the usual co-pay.  The receptionist waved me out--"You don't owe anything," she said.

Excited, I remarked to my husband that we just experienced a direct benefit of the Affordable Care Act.  Insurers are now required to offer a full range of preventive services, defined by the U.S. Preventive Care Task Force, with no cost sharing for families.

(Later, of course, the wonk in me wondered: "Is my new health plangrandfathered?") It turns out that it was, which means it was exempt from ACA's preventive services provisions.   Our HR office did tell me that my insurer made the preventive care change in response to the law, aligning it with requirements in other plans--so, OK, it's not a direct result but due to positive peer pressure, so I'll still thank ACA for the extra cash in my pocket!)

Whether or not my family benefitted directly, this is a welcome change for so many low- and middle-income families who really need the extra money in this tight economy, removing one more barrier to preventive care.  Of course, child health advocates know that Medicaid and CHIP already do this--the programs have a long history of providing affordable, preventive care services through EPSDT and most CHIP benefits.  The ACA protects and builds upon these gains for kids by requiring private plans to offer a full range of benefits with no cost sharing for families.

So how many children have actually gained access to preventive care as a result?

According to a CCF fact sheet, released today:

More than half of the nation's children have gained or maintained access to cost-effective preventive care services as a result of the Affordable Care Act. The ACA is already helping over 40 million children and their families with better access to cost-effective preventive care through a state Medicaid/CHIP program or private insurance plans.

The ACA has improved access to care in private plans by expanding the quality of preventive services provided and removing cost barriers for families.

  • Almost 1 in 5 (18.5%) U.S. children can now access new preventive services through their insurer.
  • More than 1 in 8 (13.7%) of the nation's children can now receive preventive services at no cost to their families.

More than a third of children in the U.S. rely on preventive care offered under Medicaid or CHIP. The Affordable Care Act protects gains already made in Medicaid and CHIP for children and families.

How does this impact your state? The fact sheet includes state-by-state data on the number and share of kids who have kept or improved access to preventive services.

It's remarkable what a difference the ACA has already made, even when many provisions won't go into effect for several more years.  Thanks to ACA for helping to connect more kids to preventive care (and for giving the Buraks one less thing to keep track of!).  We already have lots to celebrate for the ACA's two-year anniversary this Friday.  Hopefully by the time Maddie turns two, we'll have even more ACA successes to applaud.

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