Despite generations of health care advocacy on behalf of children with chronic diseases, these special patients have faced barriers to care within the health care system. Among other challenges, children with cancer and adults who have survived childhood cancer have encountered soaring health care costs and gaps in coverage. This article reviews the key areas of 2010 federal health care reform, the Patient Protection and Affordable Care Act, pertaining to the care of children and adolescents with cancer and childhood cancer long-term survivors.