Amend, don't end, federal health care reform

As a pediatrician, I treat children with all sorts of health ailments, from a baby who is born prematurely to a teenager with chronic asthma to a toddler who took a tumble learning to walk.

During every check-up for the young patients I care for, my No. 1 goal is to keep each child healthy. While I certainly can't prevent accidents or illnesses from happening in the first place, I can monitor, diagnose and treat health conditions once they develop.

Whether by administering preventive care; providing screenings, tests, and immunizations, or talking to families about how to make healthy choices, I can take strides to help improve the health of each child who comes through my office door.

Yet my ability to administer these critical health services has become increasingly reliant on one important document: an insurance card. Unfortunately, in many instances, my patients' forms of health insurance are as varied as their own health conditions: some have private insurance through their parents, others are enrolled in Medicaid or the Children's Health Insurance Program, and still others have no insurance at all.

No family should have to choose between putting food on the table and paying medical bills. With 10 percent of Kentucky's children uninsured, too many families are going without access to basic health services such as check-ups and immunizations that keep their children healthy. As a pediatrician, that's a hard statistic for me to swallow.

Luckily, thanks to a provision of the Affordable Care Act that took effect last September, children with complex health problems such as diabetes or cerebral palsy are now guaranteed access to the care they need. The law forbids insurance companies from denying children with pre-existing conditions access to health care, along with many other child health protections.

Yet legal challenges to the law's implementation continue to mount. Recently, the U.S. Court of Appeals for the 6th Circuit — which oversees Kentucky — heard oral arguments on the constitutionality of the Affordable Care Act. At issue is whether the law's requirement for most Americans to buy health insurance by 2014 is constitutional.

Nearly half of Kentucky's population automatically complies with this provision by having insurance through an employer, and another 36 percent already complies by having insurance through other means, such as Medicaid or an individual plan. If people don't contribute by purchasing health insurance when they're healthy, it won't be there to take care of them when they're sick. By spreading responsibility in this way, costs are lower across the board for everyone, and important protections such as the ban on pre-existing-condition exclusions for children are both possible and affordable.

I am a pediatrician, not a politician. I understand that there are parts of the Affordable Care Act that could be improved and strengthened over time. But undoing this law piece by piece in court is not the answer. Instead, we must work together to improve the law as it is implemented. We cannot undo the progress the law has made in improving the health of children, adolescents and young adults right here in Kentucky and across the country.

The passage of health reform by Congress more than one year ago marked the beginning of a much-needed focus on children's health.

We must build on this momentum and invest in children's health by preserving the Affordable Care Act.