Affordable Care Act Babies, Children & Teens

Health After Aging Out of Foster Care

U.S. teens who age out of the foster care system face health care access issues as adults, putting them at risk for lifelong health problems, a new report shows.
“Fostering Health: The Affordable Care Act, Medicaid and Youth Transitioning from Foster Care,” released October 18 by the National Center for Children in Poverty, explores the reasons for the inconsistent health coverage that many former foster youth receive after aging out of the foster care system.
The Affordable Care Act mandates that all children in foster care receive Medicaid until they transition out of the child care system on their 18th birthday, after which they can request continued health coverage from their state until age 26. In 2014, an estimated 180,000 youth aged out of the foster care system and qualified for continued health-care coverage. However, the report found that 37 states did not grant coverage to people who were seeking it in a different state from which they were in foster care, enrolled in Medicaid or both.
States that deny Medicaid coverage to former foster youth could face higher medical costs in the future, as such youth are more vulnerable to illnesses and hospitalization than their peers, the report said. States that did not expand eligibility for Medicaid to residents with lower incomes faced an increase in health-care costs of 6.9 percent, almost double that of states that did expand, according to a 2015 study by the Henry J. Kaiser Family Foundation cited in the report.
The report also noted that children in foster care are particularly vulnerable to disease. In 2012, 35 to 60 percent of such children had a chronic or acute illness that required long-term care. In 2008, 50 to 75 percent exhibited psychological problems requiring mental health treatment, according to Congressional Research Service and Children and Youth Services Review studies cited in the report. Girls in foster care are also more than twice as likely to become pregnant by 19 as their peers, according to a 2009 study by Chapin Hall Center for Children at the University of Chicago.
“No child who’s seeking an education, pursuing a job opportunity or attempting to start the next phase of life in a different state should lose health coverage,” said APHA member Renee Wilson-Simmons, assistant professor of health policy and management at the Columbia University Mailman School of Public Health and report co-author, in a National Center for Children in Poverty news release. “But many former foster youth are being forced to do just that.”
The report authors recommended that the ACA be revised, enrollment and eligibility processes be simplified and information on accessing coverage and care be provided to teens before they leave foster care.
Reprinted with permission from The Nation’s Health, APHA.

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