November 2005Vol. 6, No. 9Medicaid Spending for Children in Foster Care

A recent issue brief from the Urban Institute found wide variation among States and among different populations in the amount of Medicaid funding spent on children in foster care. Using data from fiscal year 2001 as provided by the Medicaid Statistical Information System (MSIS), the issue brief looked at categories of expenditures, variation in capitated enrollment (fixed sum per child), and variation in State spending per child. Spending variations included the following:

• Relatively more was spent on infants, adolescents, and older adolescents than on other children.
• More was spent on boys than girls.
• More was spent on Caucasian than on African American or Hispanic children.
• Medicaid expenditures were 9 percent higher for children with capitated health care spending than for those without; however, these differences varied by age, sex, and race.

The MSIS data showed that approximately $3.8 billion in Medicaid dollars was spent on children in foster care in 2001. Among States, spending per child varied greatly, from a high of $19,408 in Maine to a low of $1,309 in Arizona. There was also great variation in State reliance on different health care delivery options.

Authors of the issue brief suggest that understanding the variations in State Medicaid spending is necessary for policymaking for future Medicaid reforms, since these policies will impact the physical and mental health of children in foster care.

The issue brief, Medicaid Spending on Foster Children, by R. Geen, A. Sommers, and M. Cohen can be downloaded from the Urban Institute website at www.urban.org/url.cfm?ID=311221

Related Item

Children's Bureau Express last wrote about the issue of Medicaid spending for children in foster care in "Sampling Bias in Using Medicaid Data to Identify Children in Foster Care" in the September 2005 issue.