Health reform: What’s at stake in the Supreme Court decision

The health reform law’s fate will be decided in a Supreme Court decision that could come very soon. There are a lot of possible scenarios for how the high court might rule. One thing is for sure: a victory for the health reform law would be a victory for child health.

If the law is upheld, millions of children and families can rest easier knowing that they can get care when sick. Health reform does away with pre-existing conditions policies, helping the up to 17 million children who might have been denied otherwise. About 28 million children will continue benefiting from the Affordable Care Act’s prohibition on lifetime limits on care. And at least 2.5 million young adults can remain on their family’s insurance plan until age 26.

If the health reform law is completely struck down, then all these recent gains in child health could be lost. The worst excesses of the health insurance industry – pre-existing conditions, caps on lifetime benefits, lack of preventative care – could return, and America would face the same insurance crisis it did at the start of 2010, with 45 million Americans left without coverage.

A few other scenarios are possible. Health reform’s “individual mandate” provision, which requires nearly all Americans to carry health insurance, could be struck down while leaving the rest of the law intact. This would still be bad news, because this part of the law is what makes it possible to end pre-existing conditions policies. Otherwise, people would be able to abuse the system by only buying health insurance when they get sick.

The health reform law also means that Medicaid would get a boost, but that is also in jeopardy. Right now, health insurance exchanges and a planned expansion of Medicaid would provide coverage to as many as an additional 7 – 8 million children. Not only could those kids lose out, but the legal foundation of many federal-state partnerships like Head Start could face a legal challenge if the expansion of Medicaid is struck down.

Legal issues aside, our children need the kind of protections passed in the health reform law. If they’re upheld, it would be a victory for child health. If they’re struck down, we must go to Congress and win these protections back.