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September 2013Vol. 14, No. 7Health Care Reform and Child Welfare

While many of the broad reforms in the Affordable Care Act (ACA) are expected to benefit children involved with child welfare, there is a specific provision within ACA that will have a more direct impact on youth and families served. A stipulation in the law requires that, beginning in January 2014, States must extend Medicaid coverage to age 26 for all youth who are enrolled in the program and in foster care on their 18th birthday, or who have aged out of care. The Urban Institute recently published a paper highlighting the ways in which this reform can benefit children and families involved with child welfare.

The researchers warn that, while the benefits of this provision have potentially positive implications for the children, youth, and families involved in child welfare, successful implementation of the law will require active participation from child welfare leaders, policy experts, and advocates. Change will need to occur on the policy level as well as within the child welfare system in order to revamp service delivery, engage staff and partner agencies, and reach out to youth and families.

The report is aimed at initiating conversation about the issue so that stakeholders can begin preparing for the transition. The authors note three goals for the paper:

  1. To provide an overview of the key ACA provisions that will impact those enrolled in the child welfare system
  2. To motivate child welfare leaders to get involved in ACA implementation
  3. To suggest potential strategies for action by key stakeholders

Researchers interviewed stakeholders to gain better understanding of the potential challenges associated with child welfare-related ACA implementation. Leaders in both the health and child welfare fields expressed concern over problems arising due to the intricacies in both systems, how substantially each varies by State, and citizens' lack of understanding of both systems. Health and child welfare officials also tend to set different types of goals, with Medicaid staff working toward functions of enrollment or benefit packages and child welfare workers focusing on populations. Finally, health officials might assume that linkages to broader human service programs, such as income support programs, cover needed connections to child welfare programs.

How Health Care Reform Can Help Children and Families in the Child Welfare System: Options for Action, by Olivia Golden and Dina Emam, is available on the Urban Institute website: (640 KB)