December 2015Vol. 16, No. 9Boosting Foster Care Alumni Health-Care Enrollment

Under the Patient Protection and Affordable Care Act (ACA), youth who have aged out of foster care at age 18 on or after January 1, 2014, are guaranteed health insurance coverage under the Medicaid program until they turn age 26. Yet many former foster youth either fail to enroll or fail to maintain their enrollment until they reach age 26.

In a new issue brief, The Affordable Care Act and Youth Aging Out of Foster Care: New Opportunities and Strategies for Action, authors Dina Eman and Olivia Golden provide an overview of this provision and offer steps States can take to boost enrollment of eligible youth. First, the authors summarize some important provisions of the ACA, including the requirements for all States:

To extend Medicaid eligibility, starting on January 1, 2014, to youth formerly in foster care who were in foster care under the responsibility of the State and receiving Medicaid when they turned 18 (or the applicable higher age in a State that provides foster care assistance to a later age), and have not turned 26, regardless of income
To provide streamlined methods for eligibility determination, enrollment, and retention
To extend Medicaid coverage to age 26 for those eligible youth who aged out of foster care in their State, with the option of extending coverage to a youth who resides in the State but aged out in another State

The authors then suggest steps that States can take to improve participation in Medicaid:

Ensure that youth currently in foster care are enrolled through automated systems as they age out, without having to take action or provide verification themselves
Find and enroll youth who aged out before 2014, but are under age 26 as of January 1, 2014, and are still eligible for coverage
Train child welfare and Medicaid staff and relevant community partners in Medicaid enrollment and reenrollment for transitioning youth
Train child welfare staff and partners to help youth use their new health-care coverage, not just enroll
Shape the benefit package to best meet the needs of youth aging out of foster care
Promote continuity of services, as well as enrollment, for these youth by making continued enrollment in Medicaid until age 26 as automatic as possible
Choose the policy option to cover youth who aged out in other States and develop partnerships with other States that are frequent destinations
Explore potential State and Federal options for health insurance for youth who achieve permanency through guardianship before age 18

Dina Emam is a research associate at the Urban Institute. Olivia Golden is the Executive Director at the Center for Law and Social Policy. The issue brief was published by the State Policy and Advocacy Reform Center, an initiative supported by the Annie E. Casey Foundation and the Jim Casey Youth Opportunities Initiative.

The Affordable Care Act and Youth Aging Out of Foster Care: New Opportunities and Strategies for Action is available at http://www.clasp.org/resources-and-publications/publication-1/The-Affordable-Care-Act-and-Youth-Aging-Out-of-Foster-Care.pdf (226 KB).