In general, young adults ages 19-26 are overrepresented among the uninsured in the U.S. Estimates from the Centers for Disease Control show that 27.5% of youth in this age group were uninsured in the first 3 months of 2012, compared to 15.4% of the general population.
boy-blkshrt_000001507623Medium.jpgAccording to a 2012 article from Policy, Politics, & Nursing Practice, there are 24,000 youth who lose Medicaid coverage after aging out of foster care annually (Jim Casey Youth Opportunities Initiative puts the estimate at 26,000 youth). Due to the circumstances surrounding their involvement in the child welfare system, these youth also tend to have high rates of physical and/or mental health needs: A study from Georgetown Center on Children and Families estimates that 80% of children in foster care have a chronic medical condition.
The Affordable Care Act
There are several provisions in the Affordable Care Act that are meant to increase the number of young adults with health insurance. For example, in September of 2010 both “preexisting condition” exclusions and lifetime limits were eliminated. But not all of these provisions directly benefit foster youth, for example the much-celebrated provision that allows parents to keep their children on their health insurance plans until age 26.
Continued Medicaid coverage until age 26
The Foster Care Independence Act of 1999 gave states the option of continuing Medicaid coverage until age 21 for youth who age out of foster care. Only a few states actually implemented this option. One provision that goes into effect on January 1, 2014 will require all states to provide continued Medicaid coverage for youth ages 18-26 who have aged out of foster care. This coverage extends not just to youth who will have aged out on or after the effective date, but also to youth who have aged out since 2006 (as long as they have not yet reached age 26 and they were covered by Medicaid when they aged out).
Medicaid coverage up to 133% of federal poverty level
Also on this date, states will be required to provide Medicaid coverage for individuals with household incomes up to 133% of the federal poverty level. For the first three years of implementation, the federal government will provide states with 100% of the funding needed to cover newly eligible individuals under this expansion. Thus, even if former foster youth do not qualify for Medicaid expansion as an emancipated youth under age 26, these youth could very well fall into this second category of eligibility. As the Child Welfare League of America points out, “Many former foster youth struggle to find adequate employment, and so they fall into this group.”
Have any insights or questions about the Affordable Care Act and its impact on child welfare-involved families and youth? Leave a comment below!