On Thursday, September 6, 2018, the Congressional Caucus on Foster Youth along with First Focus hosted a congressional briefing on the Intersection of Medicaid and Child Welfare. The briefing discussed the importance of Medicaid coverage for current and former foster youth and highlighted the need to fix a glitch in Medicaid regulation affecting the former foster youth.
The panel consisted of Cathy Utz from Pennsylvania Department of Human Services, Laticia Aossey from FosterClub, Sarah Helvey from Nebraska Appleseed, and moderated by Bruce Lesley from First Focus.
Laticia Aossey spent nearly twenty-one years in Iowa’s foster care system. Laticia faced chronic medical conditions battling chronic stomach illnesses and PTSD. While in the foster care system her medical care was taken care of by the state through the state Medicaid program and thanks to a provision of the Affordable Care Act (ACA), Laticia has coverage until age 26. However, the ACA provision has barriers that prevent former foster care youth from successfully transitioning to adulthood like their peers and Laticia story is unfortunately not uncommon. (see pervious article on opioids legislation).
The ACA allows youth who age out of foster care and enroll in Medicaid to remain eligible for Medicaid coverage until the age of 26. Due to a technical problem with the way the ACA provision was written, the guarantee of continued Medicaid applies only to the state the young person was living while in foster care. This summer the House passed H.R. 4998 –the Health Insurance for Former Foster Youth Act –included in H.R. 6 (Supporting Patients and Communities Act) allowing states the option of covering former foster youth from other states. Congresswoman Bass (D-CA), sponsor of the legislation, stated that health care is a fundamental right that all children in our country should be provided. Fixing the gap in the ACA legislative language that former foster youth will not lose coverage if they leave their state and have a continuation of care to age 26 is a significant focus of the Congressional Caucus on Foster Youth.
In Pennsylvania, there are 16,000 children in foster care, and the removal reason is primarily parental drug abuse coupled with inadequate housing and neglect stated Ms. Utz. The health status of children in foster care includes 90 percent of young children with physical health problems, and 55 percent have two or more chronic conditions. Every year, approximately 20,000 youth age out of the foster care system and the Affordable Care Act allows former foster youth to keep their Medicaid coverage until age 26. Pennsylvania is a Medicaid expansion state that has automatic enrollment and renewal for young adults and one of only nine states that cover youth who relocate from another state. In most states, nearly all children in foster care are on Medicaid but in Nebraska, some children are not on Medicaid, and they do not cover out of state youth.
Laticia emphasized that once a state removes a child from their home, they assume the role of the parent. Therefore, the state should assume the responsibility of providing health coverage until the age of 26. Young people should not be in fear of losing health coverage once they age out of the foster care system or move to another state. CWLA National Blueprint for Excellence in Child Welfare states that children, youth, and families should have access to health care in their communities, and their health care needs should be met. Access to health care for former foster care youth are critical to a successful transition to adulthood.