The Affordable Care Act and Adolescents. Community Health Centers

08/01/2013

To help adolescents and adults without access to a usual source of care, the Affordable Care Act (Section 10503) invests in Health Centers.  Approximately $11 billion was appropriated over 5 years for operation, expansion, and construction of health centers throughout the nation. About $9.5 billion was provided to (1) Support ongoing health center operations; (2) Create new health center  sites in medically underserved areas; and (3) Expand preventive/ primary health care services.  By the end of this fiscal year, approximately $5 billion in Affordable Care Act resources will have been invested in health centers. Information on locations of health centers is available at: http://www.healthcare.gov/using-insurance/low-cost-care/community-health-centers/index.html.

Because of the Affordable Care Act, more Americans will have access to affordable health insurance coverage. For adolescents, the Affordable Care Act expands health insurance coverage, increases access to comprehensive benefits, and places greater emphasis on prevention and wellness.

Table 2: Key Provisions of the Affordable Care Act Relevant to Adolescents

Provisions

In Effect

Medicaid/ CHIP

Maintenance of pre-Affordable Care Act Medicaid and CHIP eligibility levels for children younger than 19

March 23, 2010 through September 30, 2019

Expanded Medicaid eligibility to 133 percent of Federal Poverty Guidelines for children ages 6-18

January 1, 2014

Required Medicaid continued coverage for some current and former children in foster care ages 25 and younger

January 1, 2014

Private Insurance

Recommended preventive services with no deductible or co-pay

Plan years beginning on or after September 23, 201016

Women’s preventive services with no deductible or co-pay

August 1, 201216

Prohibition on pre-existing conditions

Plan years beginning on or after September 23, 2010 (under 19); January 1, 2014 (all ages) 17

Expansion of dependent coverage (19-25) under parent’s health insurance

Plan years beginning on or after September 23, 2010

Guaranteed issue of health insurance regardless of applicant’s health status or other factors

Plan years beginning on or after January 1, 201418

Essential Health Benefits

Coverage of pediatric services, including dental and vision, to age 19

Beginning on or after January 1, 201419

Mental health and substance use coverage, with  federal parity requirements  

January 1, 2014

Prohibition of lifetime limits on coverage on essential health benefits

Plan years beginning on or after September 23, 2010

Prohibition of annual limits on coverage of essential health benefits

Plan years beginning on or after January 1, 201420

Health Insurance Marketplace (Exchanges)— New, transparent mechanism to shop for affordable coverage. Tax credits for eligible households below 400 percent of Federal Poverty Guidelines, for those not Medicaid/CHIP eligible.

January 1, 2014

 

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