Affordable Care Act covers kids

Pediatrics on list of essential health benefits

Editor's note: This is the seventh in a series of stories that will explain the 10 essential health benefits required under the Affordable Care Act and explore what effect those requirements will have on patients and caregivers.

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MICHAEL GAMBON as Professor Albus Dumbledore and DANIEL RADCLIFFE as Harry Potter in Warner Bros. Pictures fantasy adventure "Harry Potter and the Half-Blood Prince."

In terms of pediatrics, the Affordable Care Act (ACA) is all about expanding health coverage for children, says St. Mary's Pediatrics pediatrician Dr. Aaron Scholer.

"It's helping to insure the uninsured children," he said. "It's making sure children who are on Medicaid have access to the same services that children who are on private insurance have access to."

He said some pediatricians not accepting Medicaid patients has been an issue in the past.

"That more pertains to pediatric subspecialists or surgical subspecialists," Scholer said. "I don't know of any pediatric practice that did that. Half of our practice is state health insurance."

Pediatric services are one of 10 essential health benefits that every health plan must cover under the ACA, also known as Obamacare.

Scholer said more children being insured will help them receive their well-child physicals, as well as vision and dental screening.

While he said that it's a reasonable expectation that more children being insured will increase business for him and his colleagues, St. Mary's Pediatrics hasn't yet experienced that.

Coverage began Jan. 1 for the first wave of individuals who gained health coverage from the Health Insurance Marketplace.

He said his patients haven't been talking about the ACA.

"I actually talked to my front staff to see if they had heard anything from anybody (patients), but they haven't," Scholer said. "They've heard people talk about the CHIP program."

CHIP - Children's Health Insurance Program - is Missouri's health care program for kids. The ACA extends funding for the program through 2019.

When looking at the future of the ACA and health care, Scholer said a lot of things are going to depend on the political environment.

"It depends on what people are going to vote for as to what's going to happen," he said. "If it stays as it is, then I think it will help ensure that all children receive preventive (health) services on a regular basis."

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