Can We Go Beyond Care Process Measures to a New Child Health Policy?

Critics of the Affordable Care Act (ACA) predicted dire consequences: massive job loss, large decreases in employer-sponsored insurance, and huge increases in health care costs. In fact, none of these predictions has come true, as job growth has increased with unemployment falling,¹ employer-sponsored insurance has been stable,² and the rate of increasing health care costs has moderated.³ Overall, the uninsured rate has declined from 16% in 2010 to 9.1% in 2015,⁴ and there is evidence that quality of care is improving.⁵ How have children fared with the implementation of the ACA and what needs to be done in the future with respect to child health policy?

The article entitled “Trends in Access to Health Care Services for US Children, 2004–2014” by Larson et al⁶ in this issue of Pediatrics addresses both of these questions. Analyzing data from the National Health Interview Survey, the authors...