Health Care Reform Benefits

Family Voices, an organization devoted to family-centered care for all children and youth with special health care needs, including children with disabilities, has written a statement on the Patient Protection and Affordable Care Act (federal health care reform legislation) summarizing benefits. They give some useful examples of situations in which the benefits will be of particular interest to parents of children with disabilities.

A document on the immediate benefits available is found here. Major portions of the act do not go into effect until 2014, but in the mean time, there are many benefits that are already in place or will be soon:

• Elimination of lifetime benefits caps (beginning September 23, 2010)
• Prohibition against rescinding coverage when someone gets sick (beginning September 23, 2010)
• Prohibition against denying children coverage for pre-existing conditions (July 1, 2010)
• Requirement that young adults be permitted to stay on their parents' insurance policies until age 26 (beginning September 23, 2010)

One section of the law of importance to states is a provision that allows states new options to cover parents and childless adults up to 133 percent of the Federal Poverty Level (FPL) and receive current law Federal Medical Assistance Percentage (FMAP). Effective April 1, 2010, this expansion of Medicaid could help states like Michigan to bring in more money for mental health specialty services. This would be felt especially in the areas of services for mental illness and substance abuse (the vast majority of people with developmental disabilities already qualify for Medicaid). People with these problems who do not now qualify for Medicaid because of their status as single adults or who are just over the poverty line, could qualify in the future and also receive services that are dependent on Medicaid eligibility.

In the long run, this would probably save money for the mental health system by bringing people in early for services and avoiding expensive hospitalizations. Every $1 the state spends on Medicaid will bring in about $3 of federal matching funds and could keep the system from collapsing under the burden of huge state deficits. Not only does money spent on health care expand jobs and improve the economy, but it relieves the pressure on the mental health system and frees up money for other much-needed services.

Check out these important resources to see if you or your family member can benefit from health care reform now.