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Opportunities and Challenges for Adolescent Health Under the Affordable Care Act

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Abstract

The purpose of this commentary is to highlight some of the key policy changes under the Patient Protection and Affordable Care Act (ACA) that have the potential to improve health care services for adolescents as well as to draw attention to challenges that have yet to be addressed. This commentary stems from our prior policy research, which examined the extent to which the health care needs of adolescents were being considered in the early implementation phases of the ACA. This study was informed by a literature review and interviews with health care administrators, health policy researchers, and adolescent medicine specialists. The ACA has significantly expanded health insurance access; however, inequities in coverage and access remain. Primarily, the structure and financing of adolescent health care needs to be improved to better support the delivery of patient-centered, comprehensive care for this special population. Additionally, improvements in youths’ awareness of their benefits under the ACA as well as a greater appreciation of preventive visits are critical. Furthermore, an unanticipated consequence of the ACA is that it exacerbates the risk of confidentiality breaches through explanation of benefits and electronic health records, which can compromise adolescents’ access and utilization of health care services. Greater attention to improving and sustaining health promoting behaviors within the context of the ACA is critical for it to truly have a positive impact on adolescent health.

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References

  1. Halfon, N. L. (2014). Lifecourse health development: Past, present and future. Maternal and Child Health Journal, 18(2), 344–365.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adolescent and School Health; Health Resources and Services Administration, Maternal and Child Health Bureau, Office of Adolescent Health; National Adolescent Health Information Center, University of California, San Francisco. (2004). Improving the health of adolescents and young adults: A guide for states and communities. Alanta, GA: Centers for Disease Control and Prevention.

  3. Patient Protection and Affordable Care Act. (2010). 42 U.S.C. § 18001.

  4. Tebb, K.P., Brindis, C.D., Giordano, A., Combelick, S., Bausch, S., & Diaz, A. (2012). A shifting health landscape for adolescents and young adults: Planning for the implementation of federal health care reform in New York. Philip R. Lee Institute for Health Policy Studies website. http://nahic.ucsf.edu/download/a-shifting-health-landscape-for-adolescents-and-young-adults-planning-for-the-implementation-of-federal-health-care-reform-in-new-york/

  5. Sedlander, E., Brindis, C. D., Bausch, S., & Tebb, K. P. (2015). Options for assuring access to confidential care for adolescents and young adults in an explanation of benefits environment. Journal of Adolescent Health, 56(1), 7–9.

    Article  PubMed  Google Scholar 

  6. National Survey of Children’s Health, 2011–2012. (2012). Data Resource Center for Child and Adolescent Health (A project of the child and adolescent health measurement initiative). http://www.childhealthdata.org/browse/survey. Accessed February 2, 2015.

  7. McManus, M. A., Pollack, L. R., Cooley, W. C., McAllister, J. W., Lotstein, D., Stickland, B., & Mann, M. D. (2013). Current status of transition preparation among youth with special needs in the United States. Pediatrics, 131(6), 1090–1097. doi:10.1542/peds.2012-3050.

    Article  PubMed  Google Scholar 

  8. Wachino, V. (2015). Medicaid and CHIP enrollment reaches 10 million more than the average monthly enrolment for July through September 2013. (2015). US Department of Health and Human Service. http://www.hhs.gov/healthcare/facts/blog/2015/02/medicaid-chip-enrollment-november.html?utm_campaign=020215_hhs_healthcare_blog_medicaid&utm_medium=email&utm_source=hhs_healthcare_blog&utm_content=020215_hhs_healthcare_blog_medicaid_readmorelink. Accessed February 4, 2015.

  9. Sommers, B., & Sara Rosenbaum, S. (2011). How changes in eligibility may move millions back and forth between medicaid and insurance exchanges. Health Affairs, 30(2), 228–236. doi:10.1377/hlthaff.2010.1000.

    Article  PubMed  Google Scholar 

  10. Olson, L., Tang, S., & Newacheck, P. (2005). Children in the United States with discontinuous health insurance coverage. New England Journal of Medicine, 353(4), 382–391.

    Article  CAS  PubMed  Google Scholar 

  11. Waschino, V., & Weiss, A. (2009). Maximizing kids’ enrolment in medicaid and SCHIP: What works in reaching, enrolling and retaining eligible children. Robert Wood Johnson Foundation and National Academy for State Health Policy. http://nashp.org/sites/default/files/Max_Enroll_Report_FINAL.pdf?q=files/Max_Enroll_Report_FINAL.pdf. Accessed December 14, 2014.

  12. Buettgens, M., Nichols, A., & Dorn, S. (2012). Churning under the ACA and state policy options for mitigation. Urban Institute. http://www.urban.org/UploadedPDF/412587-Churning-Under-the-ACA-and-State-Policy-Options-for-Mitigation.pdf.2012. Accessed December 10, 2014.

  13. Polilitz, K., Tolbert, J., & Ma, R. (2014). Kaiser Family Foundation. http://kff.org/health-reform/report/survey-of-health-insurance-marketplace-assister-programs/. Accessed January 5, 2015.

  14. American Academy of Pediatrics Ad HocTask Force. (1992). Definition of the medical home: The medical home. Pediatrics, 90(5), 774.

    Google Scholar 

  15. Adams, S., Newacheck, P., Park, J., Brindis, C. D., & Irwin, C. (2013). Medical home for adolescents: Low attainment rates for those with mental health problems and other vulnerable groups. Academic Pediatrics, 13(2), 113–121.

    Article  PubMed  Google Scholar 

  16. United States Department of Health and Human Services. (2014). The Affordable Care Act Supports Patient-Centered Medical Homes in Health Centers. http://www.hhs.gov/news/press/2014pres/08/20140826a.html. Accessed December 28, 2014.

  17. Centers for Disease Control and Prevention. (2014). Use of selected clinical preventive services to improve the health of infants, children and adolescents—United States, 1999–2011. Morbidity and Mortality Weekly Report, 63(2) (Suppl).

  18. Osheroff, J. A., Teich, J. M., Middleton, B., Steen, E. B., Wright, A., & Detmer, D. (2007). A roadmap for national action on clinical decision support. Journal of the American Medical Informatics Association, 14(2), 141–145.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Fox, H., McManus, M., Klein, J., Diaz, A., Elster, A., Felice, M., & Wilson, J. (2010). Adolescent medicine training in pediatric residency programs. Pediatrics, 125, 165–172.

    Article  PubMed  Google Scholar 

  20. Hamel, L., Firth, J., & Brodie, M. (2014). Kaiser Family Foundation, Kaiser Health Tracking Poll. http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-march-2014/. Accessed February 4, 2015.

  21. The Society for Adolescent Health and Medicine. (2014). Sexual and reproductive health care: A position paper. Journal of Adolescent Health, 54(4), 491–496.

    Article  Google Scholar 

  22. Bayer, R., Santelli, J., & Klitzman, R. (2015). New challenges for electronic health records confidentiality and access to sensitive health information about parents and adolescents. JAMA, 313(1), 29–30.

    Article  CAS  PubMed  Google Scholar 

  23. Lehrer, J., Pantell, R., Tebb, K., & Shafer, M. (2007). Forgone health care among U.S. adolescents: Associations between risk characteristics and confidentiality concern. Journal of Adolescent Health, 40(3), 218–226.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors wish to acknowledge Gingi Pica, MPH, Manager, ICF International, Angela Diaz, MD, MPH, Director, Mount Sinai Adolescent Health Center and Ken Peake, DSW, Chief Operating Officer, Mount Sinai Adolescent Health Center for their valuable insights and guidance on the research leading up to this commentary. We would also like to thank all of the study participants for sharing their time and insights with us. This research was supported in part by funding from Atlantic Philanthropies and a grant from the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services (U45MC27709) to the Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco.

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Authors and Affiliations

  1. University of California San Francisco, San Francisco, CA, USA

    Kathleen P. Tebb & Claire D. Brindis

  2. New York University School of Medicine, New York, NY, USA

    Erica Sedlander

  3. ICF International, New York, NY, USA

    Sara Bausch

Authors
  1. Kathleen P. Tebb
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  2. Erica Sedlander
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  3. Sara Bausch
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  4. Claire D. Brindis
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Correspondence to Kathleen P. Tebb.

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Tebb, K.P., Sedlander, E., Bausch, S. et al. Opportunities and Challenges for Adolescent Health Under the Affordable Care Act. Matern Child Health J 19, 2089–2093 (2015). https://doi.org/10.1007/s10995-015-1737-7

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  • DOI: https://doi.org/10.1007/s10995-015-1737-7

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