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Obamacare to help close youth coverage gap

Anna Challet

Over 4 million uninsured adolescents will be eligible for health-care coverage on Jan. 1, due in part to increased Medicaid eligibility, according to a new report released by the Department of Health and Human Services.

While last year’s Supreme Court ruling on the Affordable Care Act allows states to opt out of Medicaid expansion, all states are required to increase Medicaid eligibility for children up to the age of 19.

The department says that some 10 percent of children nationwide between the ages of 10 and 19 will qualify for coverage when the ACA goes into effect in January — many of them Latino and African American.

“When you look at the statistics and you see the number of adolescents who are uninsured and eligible for benefits, 35 percent of them are Latino and 16 percent are African American,” says Wilma M. Robinson, the deputy director of the Office of Adolescent Health. “[The Affordable Care Act] is especially important for communities of color.”

The report, released by the Office of Adolescent Health and the Office of the Assistant Secretary for Planning and Evaluation, calls attention to the large number of adolescents nationwide who stand to benefit from greater access to coverage.

The percentage of adolescents who are uninsured and eligible for coverage is highest in some of the states where legislatures rejected Medicaid expansion. Texas has the highest percentage in the nation, with nearly 18 percent of eligible adolescents lacking coverage. In Florida, just over 16 percent of eligible adolescents are uninsured.

Starting Jan. 1, all states must cover children ages 6 to 18 in families with incomes up to 138 percent of the federal poverty level, or just under $27,000 a year for a family of three. Previously, the national maximum income for eligible families was 100 percent of the federal poverty level.

Robinson points out that several provisions of the ACA are already in effect for adolescents, including a ban on denying coverage to children under 19 who have pre-existing conditions, formerly a common practice among private insurers. According to the report, one in four children between the ages of 12 and 17 has special health-care needs.

“The information [about the Affordable Care Act] is coming from so many sources and it can be overwhelming at times. All the emphasis has been on the adult population … but there are unique benefits for adolescents as well,” Robinson says.

Open enrollment begins Oct. 1. To learn more about your coverage options under the Affordable Care Act, visit

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