Posts in Insurance Coverage
New Funding to Promote Value-Based Payment and Care Recommendations for Transition

The National Alliance to Advance Adolescent Health has received funding from the Lucile Packard Foundation for Children’s Health to develop a strategic dissemination plan to increase the use of value-based payment (VBP) and care delivery recommendations by payers for pediatric-to-adult health care transition. See more →

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Health Care Coverage and Access Among Children, Adolescents, and Young Adults, 2010–2016: Implications for Future Health Reforms

by Donna L. Spencer, Margaret McManus, Kathleen Thiede Call, Joanna Turner, Christopher Harwood, Patience White, and Giovann Alarcon, March 2018

This article from the Journal of Adolescent Health examines changes to health insurance coverage and access to health care among children, adolescents, and young adults since the implementation of the Affordable Care Act. The report shows significant improvements in coverage among children, adolescents, and young adults since 2010.  See more

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Comments to the Social Security Administration on Strategies to Improve Adult Outcomes for Youth Receiving Social Security Income (SSI)

February 2, 2018

Comments to the Social Security Administration regarding its Request for Information on Strategies to Improve Adult Outcomes for Youth Receiving Social Security Income (SSI), focusing particular attention to the distinct needs of transition-age youth and young adults, ages 14 to 25. See more

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Lack of Comparability Between CHIP and ACA Qualified Health Plans

by Margaret A. McManus and Harriette B. Fox, July 2014. 

This fact sheet provide a detailed examination of comparability between separate CHIP programs and child-only qualified health plans in Colorado, Georgia, Oregon, Texas, and West Virginia for children with family incomes between 134% to 300% FPL. It examines cost-sharing requirements, including deductibles, copayments and coinsurance, and out-of-pocket limits, and benefit coverage and treatment limitations in 28 benefit categories. Implications for CHIP reauthorization are also discussed. See more

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Many Low Income Older Adolescents Likely to Remain Uninsured in 2014

by Harriette B. Fox, Margaret A. McManus, and Annalia G. Michelman, October 2013.

This fact sheet identifies the states in which adolescents ages 19 and 20 living at or below the poverty level are likely to remain without health insurance protection in January 2014, despite the passage of the Affordable Care Act. It examines several avenues to state Medicaid coverage: optional Medicaid eligibility for “Ribicoff Children” up to age 21, Section 1115 demonstration waivers covering childless adults, and the ACA’s optional Medicaid expansion for uninsured individuals ages 19 through 64. It also describes the obstacles these older adolescents confront in securing private health insurance coverage through employment and in exchanges. See more

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Private Coverage Under California's Affordable Care Act: Benefit and Cost-Sharing Requirements Affecting Children and Adolescents With Special Health Care Needs

by Margaret McManus and Harriette Fox, May 2013.
This issue brief examines the extent to which California’s essential health benefits benchmark plan meets the needs of children and adolescents, including those with special needs. It also examines the cost-sharing requirements that will be used by health insurance plans sold in California’s Health Insurance Exchange. It identifies potential issues of concern in the benchmark’s essential health benefits, with special attention to families’ out-of-pocket cost liabilities within all five levels of coverage, including subsidized coverage. See more

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Comments to HHS on Proposed Rule on Medicaid, CHIP, and Exchanges

February 13, 2013

Comments from The National Alliance to the Centers for Medicare and Medicaid Services on the Proposed Rule on Medicaid, Children’s Health Insurance Programs, and Exchanges, issued on January 22, 2013, to implement provisions of the Affordable Care Act (ACA) and the Children’s Health Insurance Program Reauthorization Act (CHIPRA). See more

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State EPSDT Policies for Adolescent Preventive Care

by Harriette B. Fox, Katherine K. Rogers, and Margaret A. McManus, September 2011.
This fact sheet presents findings from an analysis of state policy documents that establish guidelines for providers delivering EPSDT preventive services to adolescents. It examines state Medicaid policies including the EPSDT periodicity schedule; comprehensive health history and developmental assessments; physical examinations, laboratory tests, and immunizations; health education; and referrals. Particular emphasis is given to the early identification of problems related to nutritional health, mental health, sexual behavior, substance use, and violence and injury potential and to health education for key topics under Bright Futures. Also examined are state policies regarding adolescents’ private time with providers. See more

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Health Reform and Adolescents

by Harriette B. Fox and Margaret A. McManus, June 2009.
This issue brief documents the significant health risks and conditions of adolescents and the financing and delivery system barriers that affect their access to appropriate care. It urges Congress to consider coverage expansions under Medicaid and CHIP, benefit and payment improvements, grant programs to support interdisciplinary models of primary care, and funds to improve training for adolescent health providers. See more

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