Report: States’ Choices Decide if Former Foster Youth Get Healthcare
|Targeted News Service|
A little-known Affordable Care Act (ACA) provision has the potential to improve the health of young adults who often have significant health care needs and are more likely to be uninsured than their peers: former foster youth. But a new report finds that, like better-known ACA provisions, states' implementation decisions will effectively determine whether these youth who have experienced abuse and neglect and spent time in foster care get access to the care they need. The Affordable Care Act and Youth Aging Out of
The paper was co-authored by
"One of the most popular parts of health reform is coverage for kids up to age 26 on their parents' insurance. The law affords equal treatment for youth who aged out of foster care, having spent time in care as a result of abuse or neglect," said First Focus President
The ACA requires states to provide
Tens of thousands of young people who have aged out of foster care in recent years are now eligible for coverage. Between 20,000 and 30,000 foster children typically age out of foster care each year, meaning that they reach the age at which foster care ends in their states without having been adopted, reunified with their parents, or placed with guardians. If effectively implemented, the ACA provision could cover nearly 100,000 young adults through 2017 alone.
The paper recommends eight steps states can take to maximize the provision's reach and value:
* Automatically enroll children aging out of foster care this year;
* Coordinate child welfare and
* Train Medicaid agency staff on the ACA's special eligibility and benefits provisions for former foster youth;
* Train child welfare agency staff to help former foster youth - many of whom have been uninsured their entire adult lives - get the care they need;
* Design Medicaid benefits that respond to the distinct health needs of former foster youth, by connecting
* Recognize that former foster youth typically face extraordinarily unstable lives, and prioritize continuity in health care as a way to offer stability;
* Ensure that former foster youth who aged out of care in other states can cross state lines without becoming uninsured, and
* Explore strategies for ensuring that former foster youth who enter guardianship rather than aging out also can count on health insurance.
"This provision matters greatly to the life prospects of former foster youth, because the research shows that they experience disproportionate health and mental health challenges compared to other young adults," said Golden. "It is a particularly powerful example of the broader potential of the ACA to open doors for poor and vulnerable families, including those involved in the child welfare system, by treating medical and behavioral health problems that previously caused enormous suffering and hindered success in school, on the job, and as parents."
While the ACA provision is new, some states have experience to build on in implementing these steps.* For example, take step 1, automatic enrollment.
"States can be heroes for young people facing incredible odds, but that means making the right policy choices," said Lesley.
The Affordable Care Act and Youth Aging Out of
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