Extending Medicaid to 26 – A New Policy Brief!

The Center for the Study of Social Policy has released a new policy brief, The Affordable Care Act and Implications for Former Foster Youth, addressing the Medicaid regulations extending coverage until youth turn 26.

As highlighted in the brief, 41% of foster youth between the ages of 18-26 do not have health insurance, while these foster youth are almost more than twice as likely to struggle with mental health problems and have significantly higher rates of health needs in general. Despite the understandable need for easier access to healthcare, foster youth have fewer options in comparison to their peers. Medicaid is essential in providing the necessary care and insurance to foster youth as they transition into adulthood.

To better address the needs of children in foster care, provisions in the Affordable Care Act, and the corresponding regulations, extend Medicaid to former foster youth until age 26. To qualify for the extension of Medicaid, the youth must have been in foster care at the time of their 18^th birthday, or have aged out of foster care based on their states’ age limits, and have been enrolled in Medicaid. These current Medicaid regulations require foster youth living within the state to receive eligibility for extended coverage.  However, coverage is important no matter where a young person grows up – so while it is only an option to provide coverage to youth who move from another state – it serves as an important support to these youth. 

The brief provides recommendations to states to maximize the health of children formerly in their care, including:

1. Elect the option to provide Medicaid coverage to former foster youth in different states.
2. Create an automatic enrollment process for youth prior to aging out of care.
3.  Implement a one-time Medicaid eligibility determination until the age of 26.
4.  Engage former foster youth and child welfare workers in designing an outreach campaign to identify successful outreach strategies in hopes of increasing the number of youth who enroll under this provision.
5. Select the most appropriate managed care program, instead of automatic enrollment for state-selected plans, for foster youth when possible.
6. Educate all child welfare agency representatives about the process of enrollment and to implement integrated care models, such as Health Homes.
7. Work with Medicaid agencies to coordinate enrollment eligibility of former foster youth even after the age of 26.

Medicaid provides a concrete support for young people transitioning into adulthood. To learn more about concrete supports that help youth to thrive, please read CSSP’s brief on Concrete Supports in Times of Need. For more results-focused policy strategies for children, youth and their families visit PolicyforResults.