The ABCs of children's health: Potential impact of the patient protection and affordable care act

In 2010, US health care spending reached approximately $2.59 trillion, or $8,402 per person (Centers for Medicare and Medicaid Services, 2012). Despite greater per capita spending relative to other industrialized nations, the United States has lower performance on several health outcome measures for both the child and the adult populations (OECD, 2011). In 2009-10, in an effort to reform the US health care system, the Obama Administration made health care top domestic policy priority. After a long and contentious debate in Congress the Patient Protection and Affordable Care Act (ACA) was passed on March 23, 2010. As implementation proceeds, provisions within the ACA have begun to alter the financing and delivery of health care for millions of Americans, the most noteworthy being a large-scale expansion of affordable coverage options for lower-income children and adults beginning in 2014. The ACA is a comprehensive piece of legislation and is expected to affect access to health insurance by children and adults, their health care related spending and financial burden, and their consumption of medical care - in other words, their ABCs. This chapter focuses on identifying the potential effects of the Affordable Care Act for children. For each of the ABCs - access, burden, and consumption - we summarize current knowledge from the research literature and then identify and briefly describe important provisions from the ACA that are expected to influence these outcomes.