How the ACA Helps Low-Income Parents–and Children–Succeed

By Olivia Golden

A few weeks ago, President Obama announced that 8 million people have signed up for health insurance through the Affordable Care Act’s (ACA) exchanges; 28 percent (about 2.2 million) were between ages 18 and 34.  But also important for young adults is the opportunity to sign up for Medicaid, which provides health care for low-income people and, unlike the exchanges, does not have a deadline.  

Within this group is a large number of low-income parents—and the correspondingly large number of young children whose early life is shaped by these parents’ caregiving. For example, a national sample of infants found that half of the babies living in poverty had mothers age 24 or under and another one-fifth to one-quarter had mothers between 25 and 29.

Meeting these mothers’—and fathers’—physical and mental health needs can help them succeed in school, in job training, in the workplace, and as parents. 

Prior to the ACA, many of these low-income parents had no insurance coverage for their own physical or mental health after the birth of the baby. While a baby’s own health appointments could be covered by Medicaid or CHIP, as could a mother’s appointments during pregnancy, a typical state set Medicaid eligibility levels for mothers after delivery as low as 60 percent of the federal poverty level. Without Medicaid, options were scarce for young parents working at low-wage jobs, which far too often came with no insurance.  The ACA has torn down these barriers, at least in the 26 states and the District of Columbia that have taken the option to expand Medicaid for low-income adults. 

The inclusion of mental health services in the ACA benefit packages is especially valuable. Among low-income parents from high-poverty communities, unmet mental health needs stemming from trauma, stress, and exposure to violence are a key barrier to school and work success and can affect their parenting practices. This is particularly an issue for people of color, who are far more likely to live in communities of concentrated poverty where violence and trauma are prevalent.

Unfortunately, parents’ untreated physical and mental health problems affect young children’s development and contribute to disparities in school readiness and children’s later life success. For example, maternal depression, widespread among low-income mothers of young children, is highly treatable, but when untreated, it risks children’s cognitive and emotional development as well as their safety. In the past, low-income mothers with depression have been far less likely to get treatment than better-off mothers, with lack of financial access an important reason.

When parents can get the physical and mental health treatment they need, their life opportunities and their children’s opportunities should improve dramatically. Giving millions of people access to new insurance coverage is a crucial first step towards this vision.