A Message from AAP President Robert W. Block, MD, FAAP
The U.S. Supreme Court will soon announce its decision on the constitutionality of the Affordable Care Act. There has been no shortage of speculation by the media, politicians and legal experts on how and when the Court might rule, but no matter what the Court decides, the AAP will continue to do what we have always done: advocate for a health care system that provides children with the “ABCs.” That means Access to health care services, age-appropriate Benefits in a medical home and health care Coverage for all children in the United States.
The Academy’s 82-year history of advocating for the best possible health care for children formed the foundation for the Early and Periodic Screening, Diagnosis and Treatment benefit within the Medicaid program, the Vaccines for Children program and the Children’s Health Insurance Program. This foundation remains strong in our members and in our mission, and guided the Academy’s approach to health reform for children two years ago.
Because the Affordable Care Act addressed the AAP's goals of access, benefits and coverage and provided many more gains for child health—including increased payment in the Medicaid program—the Academy endorsed the legislation and argued for its constitutionality in three separate briefs to the Supreme Court. AAP chapters have led the law’s implementation for children at the state level, working with governors and state legislators across the country.
What hasn’t been said enough during the speculation leading up to the Court’s decision is all the law has already done for children. For the past two and a half years, children across the country have benefited from these reforms:
guaranteed coverage for children with pre-existing conditions
no more lifetime coverage limits
restrictions on annual coverage limits
essential preventive care services (as recommended by Bright Futures) provided with no cost-sharing for families with new health insurance plans
insurance companies can no longer drop coverage when a child or adult gets sick
young adults can stay on their parents’ health insurance until they turn 26
out-of-pocket expenses are capped at $5,950/individual and $11,900/family
parents can designate a pediatrician as their child’s primary care provider
The Academy’s hope is that when the Court issues its decision, these gains will be preserved along with a host of other achievements yet to take effect. That includes, for example, an unprecedented increase in Medicaid’s 2013-2014 payment rates, an expansion of the Medicaid program to cover even more low-income families, and the establishment of health insurance exchanges for consumers to choose a health plan that’s right for them (and get a tax credit to defray the plan’s cost).
But we also must plan for alternative outcomes: that the Court may strike down parts of the law and preserve others, or that the entire law may be deemed unconstitutional. Academy leaders have explored various scenarios as to what each outcome could mean for the “ABCs” that anchor the law and our decades-long advocacy. We’ve prioritized how to protect the law’s child health gains and identified new ways to advance our goals through a variety of mechanisms at the state and federal levels. When the ruling is announced, expect a message from the Academy on the decision, and stay tuned for additional analysis explaining what the outcome means for children and pediatricians.
Of course, I will be anxiously awaiting the Court’s decision. I know how much progress we’ve made through the Affordable Care Act in providing children with access, benefits and coverage, and I would hate to see the law overturned.
I don’t know how the Court will rule, but I do know one thing: No matter what the outcome, the collective voices of the Academy’s 60,000 pediatricians speaking up for children will be far from silent.
Thank you,
Robert W. Block, MD, FAAP
President, American Academy of Pediatrics