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Kids, Adults With Disabilities Can Fear Less Thanks to SCOTUS

Kids, Adults With Disabilities Can Fear Less Thanks to SCOTUS

I was definitely among those Americans breathing a huge sigh of relief on learning yesterday that the Supreme Court upheld most of the provisions of President Barack Obama’s Affordable Care Act. Among the myriad concerns my husband Jim and I have on our minds as our teenage son Charlie, who’s on the moderate to severe end of the autism spectrum, approaches adulthood is providing for his medical care.

The ACA’s provision that children can stay on their parents’ health insurance under they are 26 makes a huge diference for Charlie and for other kids and individuals with disabilities. It is very uncertain what sort of employment (if any) Charlie will have after he finishes school when he is 21 years old and definitely up in the air if a job for him would come with insurance.

ACA Benefits Individuals With Disabilities

As Nirvi Shah writes on Education Week’s On Special Education blog, some of the law’s other provisions make a big difference for families with children with disabilities. Under the ACA, lifetime caps on coverage that many insurance companies now have are removed. Shah quotes Dr. Paul Lipkin, who specializes in the care of children with developmental disabilities, cerebral palsy and other conditions, as saying that “For a person with chronic health issues, lifetime caps have always been something that have been feared.”

A child with CP or severe epilepsy could certainly need a great deal of medical care, with accompanying expenses. Families cannot simply seek our difference insurers as their children’s disability is considered a preexisting condition and a reason to be denied coverage.

Other benefits provided in the ACA for individuals with disabilities are :

  • The ACA establishes the Community First Choice Option, which can help support community living for individuals with disabilities by providing states with the opportunity to receive increased federal matching funds.
  • The ACA requires insurances plans to cover a  number of “essential benefits” including mental health services, habilitation and rehabilitation services and behavioral health treatment (this latter is of particular concern to families with autistic children).

A Caveat About Medicaid

The one setback, noted by Disability Scoop, concerns Medicaid. While the Court affirmed most of the ACA, the justices did rule against a provision that required that states expand Medicaid to include people earning up to 133 percent of the federal poverty level (about $14,856 for a single person) or lose federal funds. People with disabilities would not be eligible for Medicaid if they earn too much, notes Marty Ford, director of public policy at The Arc, should the Court’s ruling leads to states deciding not to expand Medicaid.

I can imagine such a scenario happening to Charlie. He will not be earning much in whatever job (most likely part-time) that he is able to get. It would be a bit ironic (though hardly unheard of) if he earned just enough to place him above 133 percent of the federal poverty level and then had to stop working to qualify for Medicaid for his health coverage.

Overall, the upholding of the ACA is simply good news for individuals with disabilities. As Katy Neas, senior vice president of government relations at Easter Seals says in Disability Scoop:

People with disabilities and their families have their lives dictated by the status of their health insurance. The Supreme Court’s ruling today tells these families they can make decisions about what is best for them as a family, and not be controlled by fear of losing health insurance coverage.

 

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24 comments

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9:32AM PDT on Jul 2, 2012

People with disabilities have a name for the rest of us; they call us TABs (Temporarily Able Bodied). They know what we fail to realize; that they are now where we will be. It's not a matter of if, simply when. Age will take its toll with degenerating joints and degenerating discs, pinched nerves, heart and kidney disease, etc. They aren't exceptions, they're the rule. And they're blazing a trail that we will follow.

9:41AM PDT on Jul 1, 2012

The U.S. is just nuts. Why on earth don't you just say no to very greedy "health" insurance company and embrace national health care. If your son is autistic in Canada, he always has health care as does everyone. Period end. No increased rates for "pre-existing" conditions, no making you feel guilty for being sick, no co-pays, etc.

The U.S. does not understand that when your citizens are not in constant terror of losing their health insurance and/or losing everything because they are sick, they become far more productive and happy people.

3:11AM PDT on Jul 1, 2012

Steve R., my family was in the position that you belly-ache about for 29 years, and we were turned down for assistance everywhere we applied. So I just buckled down and kept working where I was because at least I had great health insurance there and a decent wage. However, I don't begrudge anyone the opportunity for assistance, and I hope that if they truly need it that they are able to find it, and yes I know some of my tax dollars are going to pay for them, even though I was never able to receive any help. I also believe that we were refused due to "discrimination" by the person sitting behind the desk at the time, and the supervisor, but that was a long time ago, and over the years the state did not make the available programs public knowledge or readily accessible, but that is also a long time ago. You, sir, just sound like a bitter soul and have not adjusted to your situation, nor do you seem to want to. With an attitude like that, you will have a miserable existence. Helping others, helps you more in return, regardless of what some of the hard right says.

10:25PM PDT on Jun 30, 2012

you will have to work hard to keep it

8:59PM PDT on Jun 30, 2012

Thanks

6:56PM PDT on Jun 30, 2012

Carole C. the ruling will kill people through the death panel. Do you know in the bill there will be a commitee in Washington who will decide if health care is warrented for an individual. That is buracrats who will come between your doctors and your decision. In the case of the autistic child should he need additional medical care the comittee might decide he should not get a procedure because he isn't worth it to socity to save his life.

6:47PM PDT on Jun 30, 2012

At least the ACA passed. That is a plus. But they are forever screwing the poor by cutting services.

3:02PM PDT on Jun 30, 2012

". . . by providing states with the opportunity to receive increased federal matching funds." Why don't they simply leave the money in the states in the first place?

10:49AM PDT on Jun 30, 2012

I'm glad people with disabillities are now save under their parents' plans, but the fact that they could be ruld inelgiable if they make too much money is appalling. Just because someone earns a certian amount of money on month does not meant that that's steady income. By the time thwy had to reapply, they could be very sick.

10:35AM PDT on Jun 30, 2012

Dear Steve R.... May you find peace, prosperity, good health, and happiness. May you find love for both yourself and for all of your human family.

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