Future Health Implications


Characteristic

Adopted CSHCN (total)%

Foster care %

Private domestic %

International %

Percent

100

46.3

34.7

19

Private health insurance

1.95

2.14

3.10*

3.11*

No Siblings

1.88

2.52

3.55*

4.06*

> 2 siblings with SHCN

1.29

2.31

.73*

3.02*


*p <0.05 when compared to total adopted population



As noted in Chap. 3, an increasing number of adoptees have complex healthcare needs. The implication is that fewer children adopted internationally will successfully transition to adulthood. Transition planning for this group will become critical. Their access to public insurance, and state sponsored programs to support adults with special health care needs may be limited.



Healthcare Coverage for Intercountry Adoptees


Prior to the Accountable Care Act (ACA), individual and other smaller health insurance plans could exclude children adopted internationally for pre-existing conditions. This meant that some children adopted internationally were not covered under their parents’ existing insurance plans in the United States. As of 2014, all but those on grandfathered individual health insurance plans will be covered. In addition, they can now stay on their parents’ health insurance coverage until the age of 26. Further, the removal of lifetime caps on essential medical benefits will also be advantageous for these families. In the recent past, many families of international adoptees exhausted the mental health and therapy benefits quickly. These families found themselves having to pay out of pocket for additional expenses. Until the ACA is fully implemented, families will continue to struggle to obtain services for their children adopted internationally. Even with the ACA, those families purchasing health care plans from the federal exchanges may find they have high annual deductibles to meet. This will place a further burden on families seeking care for children with special health care needs long term.

Even with these changes, medical bills can be a strain for families adopting children with increasingly complicated medical needs. Often children adopted domestically with SHCN are insured by Medicaid through Social Security and Disability benefits. These benefits will remain intact into adulthood. The criteria for eligibility almost always excludes those born outside of the United States. The ability for children born outside of the United States to qualify for these same benefits varies by state (Table 5.2). Lifelong planning for children who are unlikely to reach independence at adulthood is critical for families considering intercountry adoption of a child with complex medical health needs.





































May Approve
 
Alabama

Nebraska

South Dakota
 

Georgia

New Hampshire

Texas
 

Hawaii

Ohio

Vermont
 

Indiana

Oklahoma
   

Michigan

South Carolina

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Jun 23, 2017 | Posted by in OBSTETRICS | Comments Off on Future Health Implications

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