The Affordable Care Act (ACA), enacted in March 2010 and taking full effect in January 2014, increases the number of people who have access to health insurance, simplifies insurance enrollment, requires that benefits include substance abuse and mental health coverage as well as medical services, and promotes innovations to help coordinate the fragmented delivery of care. All these changes, if implemented fully and carefully, would be particularly valuable for the highly vulnerable children and families in contact
with the child welfare system. These families frequently have substantial health and mental health needs, lack insurance coverage completely (parents) or experience gaps in coverage when their circumstances change (children), and find the complex world of health insurance and health care difficult to navigate. For these vulnerable families, health care reform is truly, in the words of one expert we interviewed, “the biggest social service change in decades.”