The Impact of ACA on Child & Family Care

1. The Impact of the Affordable
Care Act on Child & Family
Care
Reina Salazar & Lydia Kim

2. ● The Affordable Care Act (ACA) consists of the Patient Protection
and Affordable Care Act (P.L. 111-148) and the Health Care and
Education Reconciliation Act of 2010 (P.L. 111-152) (Medicaid,
2014a).
● These combined laws expand upon the services covered by
Medicaid
● More children from low-income families will now have access to
health care services & insurers must now cover more services at
no cost to the consumer
● Children under 19 with pre-existing conditions now can’t be denied
coverage by insurers (Hutson, 2012)
Background

3. • Emergency services
• Hospitalizations
• Laboratory services
• Maternity care
•Mental health and
substance abuse treatment
ACA Benefits
• Outpatient, or ambulatory, care
• Pediatric care
• Prescription drugs
• Preventive care
• Rehabilitative and habilitative (helping
maintain daily functioning) services
• Vision and dental care for children
Effective January 1, 2014, all individual health plans and those sold to
small businesses must offer a comprehensive package of benefits that
includes:

4. ● Increased emphasis and funding for early intervention (detection,
prevention, and management)
● Insurers must now fully cover:
o Preventative services for mothers, children, and adolescents
o Vaccinations
o Screenings for autism & general development
● Preventative services include
o obesity management and prevention
o 26 services are now covered
http://www.hhs.gov/healthcare/prevention/children/index.html
Impact on Child & Family Services

5. ● Advantages:
o increased funding for early intervention, and prevention &
management of chronic conditions
o expanded role in screening for conditions, such as autism and
developmental delays
● Potential Disadvantages:
o OT might be under threat from other professions trying to
expand their role
o Reimbursement for therapy services might be lower than
normal hourly rate
● Overall, the impact of the ACA on preventative and wellness
services is largely positive
Impact on OT Profession

6. ● Due to the governmental support and increased funding for
preventative and wellness services, OTs can expand their role
● Implement or consult on preventative and wellness programs in
schools and other places in the community
o fitness programs (obesity prevention and management)
o Programs for children and adolescents with autism, mental
health disorders, etc.
Suggested Courses of Action

7. ● Centers for Medicare & Medicaid Services (2014). Readmissions Reduction Program. Retrieved
from http://www.cms.gov/Medicare/Medicare-Fee-for-Service-
Payment/AcuteInpatientPPS/Readmissions-Reduction-Program.html
● Hutson, B. (2012) Health Reform: seven things you need to know now. Consumer Reports
Health. 1-16. Retrieved from https://consumersunion.org/wp-
content/uploads/2012/10/The_Affordable_Care_Act-You_and_Your_Family.pdf
● Medicaid.gov (2014) Affordable Care Act. Retrieved from
www.medicaid.gov/AffordableCareAct/Affordable-Care-Act.html
● Koh, H.K., & Sebelius, K.G. (2010). Promoting prevention through the Affordable Care Act. New
England Journal of Medicine, 363:1296-1299 DOI: 10.1056/NEJMp1008560
● Unites States Department of Health and Human Services. (2014). Prevention & wellness:
Prevention care for Children. Retrieved from
www.hhs.gov/healthcare/prevention/children/index.html
● Unites States Department of Health and Human Services. (2014). The Affordable Care Act and
the School-Based Health Center Capital Program. Retrieved from
http://www.hhs.gov/healthcare/facts/factsheets/2011/12/sbhc.html
References