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Jimmy Kimmel Brings Attention to Consequences of Repeal of Healthcare Laws for Infants

By: Cohen, Placitella & Roth @ Jun 26, 2017

In late April 2017, Jimmy Kimmel and his wife welcomed a newborn baby boy into the world named Billy. While the birth went well, within a few hours, Billy began changing colors, and ultimately required emergency surgery to treat a condition called tetralogy of Fallot.

Thankfully, Billy is OK, although he is now one of the millions of Americans who has a preexisting condition. While the Affordable Care Act (ACA) currently protects those with preexisting conditions from being denied health insurance coverage, and offers other provisions that are specific to infant care, these protections may be lost if the ACA is repealed and replaced with the new Republican-backed bill.

Understanding the Provisions of the Affordable Care Act

As explained in an article published in The New York Times, here is a primer on how infant healthcare worked pre- and post-ACA:

Before the ACA was passed, federal law did provide some protections for newborn babies, such as the requirement that employer-sponsored plans cover newborns, even if they were born with health conditions necessitating out-of-the-ordinary medical care, so long as parents enrolled their new babies within 30 days of birth. Federal law also required that if a parent was to change their job, the new insurer (again, for an employer-sponsored plan) could not charge more for the newborn’s coverage if the newborn was sick, nor could they impose a waiting period.

Unfortunately, one of the biggest areas where federal law was lacking is that it failed to offer these same protections to parents who bought private insurance, rather than employer-sponsored insurance.

For all insured parents – private or employer-sponsored alike – each state in the nation required that newborns be covered under their parents’ insurance policy pre-ACA. However, states did not require that an insurer cover a baby if the parent was privately insured and switched plans, and allowed for insurers to refuse coverage to a sick child, or charge a parent more. In other words, insurance companies were allowed to discriminate against infants with pre-existing conditions, often forcing parents to pay much more than they could comfortably afford for coverage, or go without coverage entirely. Another huge problem with pre-ACA law was limits on coverage – in some cases, infants met their lifetime coverage limits within a few years.

Changes if ACA Is Repealed

If the Affordable Care Act is replaced with the new legislation that is supported by President Trump, the ability for insurers to discriminate against children like Billy, who suffer from preexisting conditions, could be reinstated (states would have the option to opt out of the protection that prevents companies from charging higher premiums to those with preexisting conditions). Equally as worrisome is the fact that the bill proposes huge cuts to Medicaid, which insures half of all newborns.

No Parent Should Be Forced to Make a Decision About Saving Their Child’s Life

A replacement of the ACA could very well mean that parents are forced to make decisions about whether or not they can afford to save their children’s lives, a predicament that no one should ever be placed in, and certainly not in the wealthiest country in the world.

At the law offices of Cohen, Placitella & Roth, P.C., we believe that you and your child deserve the highest quality care. If you are harmed by a breach of the duty of care owed to you or if your child suffers a birth injury, contact us for a free consultation.

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