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In a recent commentary in Health Affairs Forefront, Gilbert Gimm, Melissa Villodas, and colleagues from the University at Buffalo and the University of Alabama shed light on barriers that former foster care children (FFCC) encounter when they become adults at age 18. Despite Medicaid eligibility being guaranteed for all former foster care children between ages 18 and 26 under the Affordable Care Act (ACA), more than 20,000 transition-age foster youth are at risk of losing Medicaid coverage every year.
Gimm, Villodas, and their colleagues summarize the challenge of varying state Medicaid policies and offer recommendations to ensure continuous Medicaid coverage for all foster youth aging out of the child welfare system as follows:
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Transition-age foster youth who turn 18 must complete Medicaid re-enrollment paperwork in many states to avoid losing Medicaid coverage at age 18, unlike young adults who automatically keep private coverage through their parents’ plans.
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Foster youth who turn 18 are at increased risk of Medicaid disenrollment when they become disconnected from social workers, therapists, or temporary guardians who can help with gathering and submitting Medicaid re-enrollment paperwork.
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Some state Medicaid websites lack information on Medicaid eligibility for foster youth who turn 18 years old. Improved website accessibility and information on Medicaid eligibility can help more transition-age foster youth and their caseworkers prepare early to gather the paperwork needed for Medicaid re-enrollment.
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Automatic Medicaid reenrollment should be a “best practice” in more states for transition-age foster youth, so they can maintain continuous Medicaid coverage and access to care, which is guaranteed by the ACA from age 18 until 26.
Former foster care children (FFCC) are individuals who have aged out of the foster care system after turning 18. The transition to adulthood (18-26) is especially challenging for foster youth with disabilities, who rely on Medicaid to maintain access to health care and medications needed to manage chronic health conditions. Implementing automatic Medicaid re-enrollment can greatly improve access to services between ages 18 and 26.
“It seems unreasonable to expect all foster youth at age 18 to become fully formed adults who prepare their own Medicaid re-enrollment paperwork, obtain paid employment, and secure affordable housing,” said Gimm.
Previous Medicare research by Gimm
Research about youth by Villodas
About the researchers
Gilbert Gimm PhD, FGSA, is an associate professor and director of the Health Services Research PhD program in the Department of Health Administration and Policy at George Mason University’s College of Public Health. Gimm is an expert in disability and aging, program evaluations, and health care financing. His research has included social isolation, family caregiving of older adults with dementia, and substance use among youth and young adults with disabilities. Prior to joining Mason, he conducted an evaluation of the Medicaid Buy-In program which aimed to support employment and maintain continuous Medicaid access for working-age adults with disabilities.
Melissa L. Villodas, PhD, LMSW, is an assistant professor in the Department of Social Work in the College of Public Health. Her research focuses on understanding how social determinants of health impact the mental health of vulnerable young people while considering how to address these challenges through treatment and initiatives at various levels. Villodas’s expertise encompasses three key areas: neighborhood environment and social determinants of health, policy, systemic, and community influences on mental health and well-being, and mental health interventions and support services.