The Clock is Ticking, Open Enrollment for Children with Pre-Existing Conditions Underway

For the first time in history, every child in California is now eligible for health insurance coverage. But it’s up to parents to take advantage of these opportunities to get better care and coverage for children, and more economic security for their families.

This wasn’t always the case, even for kids whose families were willing to buy insurance at any cost. Some children were denied coverage because of pre-existing conditions.

The new federal health law, the Patient Protection and Affordable Care Act, provides welcome relief. On Sept. 23, 2010, a key provision took effect that bars children from being denied coverage due to their health status.

In reaction, many of the larger health insurers in California announced that they would stop selling “child-only” policies—insurance for the children in a family, but not the parents—because they worried that parents would wait until their kids got sick before buying coverage. That enraged many parents.

Assemblyman Michael Feuer, D-Los Angeles, came to the rescue by introducing a bill that penalizes insurers who refuse to sell child-only policies by banning them from the broader individual market for five years. Insurers quickly realized that they couldn’t afford to jeopardize their bottom line – some 2.5 million Californians buy their own insurance. The insurers rejoined the children’s market as the state law went into effect January 1.

The California law goes a little farther than the federal law in that it also limits how much insurers can charge for children with pre-existing conditions, provided that they sign up during an open enrollment period. Under the state law, insurers cannot charge a child with health issues more than twice what they charge a healthy child.

This is an important improvement. The federal law prohibits outright denials, but it does not place a limit to what insurers can charge due to health status.

In order to get the price protection, children must be signed up during the open enrollment period, from January 1 through March 1. Other enrollment periods include the month of a child’s birthday and changes in family circumstances, such as a job switch, marriage, divorce, or a move to California.

The families that will take greatest advantage of the new law will be those who get their coverage through an employer but don’t elect dependent coverage for their kids. While this may represent only a small slice of California, it’s still tens of thousands of kids who now have new access—and new affordability—because of both the state and federal law.

The new law also builds on years of work to expand public programs, which provide subsidies to low- and moderate-income families under Medi-Cal and Healthy Families. Many children are eligible to enroll in these program, but don’t take advantage.

A great way to start the New Year is to make sure that every child you know is covered— whether by private insurance or public programs. For the first time ever, we have the tools to make the new federal health care reform law work.

Countdown clock courtesy of the 100% Campaign, please visit 100percentcampaign.org for more information on winning coverage for all children in California.

Health Access California promotes quality, affordable health care for all Californians.

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