Loophole in Affordable Care Act Exposes Foster Care Youth to Losing Medicaid

Print More

From The Chicago Bureau:

After four years, more detailed points of Obama’s Affordable Care Act are just now getting enacted, including new provisions for foster youth. The most sweeping change in the Affordable Care Act is that youth can stay on their parents’ insurance until age 26, which excludes children in foster care.

The Chicago BureauFrom Jan. 1, 2014, all foster youth are eligible for Medicaid until age 26, as long as they were on Medicaid while in foster care and turned 18 while in foster care. But this has created some problems with youth who move across state lines. The fact that youth could only be able to get Medicaid coverage in the same states in which they were in foster care makes many youth ineligible for coverage. Language in the Affordable Care Act makes it entirely up to the state to decide whether to uphold their Medicaid.

While this state option has been available since January, only 12 states to date — not including Illinois — have taken steps towards it. This is why the First Focus State Policy Advocacy and Reform Center (SPARC), a group dedicated to improving the lives of children and families involved with the welfare system, released a report outlining and summarizing the details of these new provisions.

“We felt like now was a good time to push it back on the agenda and on the radar for folks,” said SPARC Director Shadi Houshyar, who wrote the report.

Houshyar said that while the group was waiting to see if more states would take action, as of now things seem to be in a lull — making this the perfect time to publish the report she has been researching for months. It details the new mandatory Medicaid coverage for foster youth, discussing relevant activity from the Centers for Medicare and Medicaid Services (CMS).

One of the most important issues CMS has addressed recently is how states should deal with the new provision for foster youth. The rule it issued is that youth should only be able to get Medicaid coverage in the same states in which they were in foster care — giving states the option to cover youth from different states, but not requiring that they do so.

Yet only 12 states have extended Medicaid coverage to foster kids who have aged out of care in a state different than their own.

“Unfortunately, with a majority of states opting to not cover youth aging out in other states, many young people will be left without essential medical coverage,” SPARC reported.

Still, many states have recently begun opting in to providing these youths with Medicaid coverage — Michigan has taken advantage of the option since fall of 2013, and Virginia recently enforced the provision in July. Sen. Mary Landrieu, D-La., made her intent clear since before the Affordable Care Act was even signed into law by advocating for foster youth in December 2009.

“We have failed them once and we just can’t fail them twice,” Landrieu said. “We must support their transition to adulthood, and guaranteeing access to quality health care will help with that transition.”

According to the report, “the lack of guaranteed health coverage creates an unnecessary hurdle for these youth,” in some cases prohibiting America’s 400,000 foster youth from going to college or taking new job opportunities. As more states and policymakers become aware of the problems facing foster youths, however, the barriers may start decreasing.

“Medicaid plays a vital role in the lives of children and youth in foster care by providing access to essential health care and supportive services,” says a report co-written by members of the Georgetown Center for Children and Families and the New England Alliance for Children’s Health. From prescription drugs to psychiatric care, the “importance of Medicaid … cannot be overstated,” authors of the report say.

The 12 states that currently extend Medicaid coverage are California, Georgia, Kentucky, Louisiana, Massachusetts, Michigan, Montana, New York, Pennsylvania, South Dakota, Wisconsin and Virginia (pending a state plan amendment).

This story was produced by The Chicago Bureau.