Access to Care for Children with Chronic Health Conditions in the ACA

Gilbert Gonzales, University of Minnesota
Lynn Blewett, University of Minnesota

As of September 2010, the Affordable Care Act (ACA) required health insurers to no longer exclude children from enrollment due to a pre-existing condition. We used data from the National Health Interview Survey to compare changes in health insurance coverage and access to care before and after the ACA’s guaranteed issue requirement between children with (n=15,661) and without (n=50,835) chronic health conditions. Insurance purchased on the individual market increased by 1.9 percentage points (p<0.05) for adolescents with chronic conditions relative to the trend for adolescents without chronic conditions. Adolescents with chronic health conditions also experienced reductions in delayed and forgone care due to cost, by -3.3 (p<0.001) and -1.9 (p<0.05) percentage points, respectively. Similar results were not found for young children. This study provides early evidence that guaranteed issue requirements in the ACA strengthened access to insurance and medical care for adolescents with chronic health conditions.