Columbia University Mailman School of Public Health

Fostering Health: The Affordable Care Act, Medicaid, and Youth Transitioning from Foster Care

Authors: Renée Wilson-Simmons, Amy Dworsky, Denzel Tongue, and Marikate Hulbutta
Publication Date: October 2016

A provision of the Affordable Care Act (ACA) requires states to continue to provide health insurance to young people who have aged out of the foster care system until their 26 th birthday.  Although the intent of the provision is to mirror the extended coverage available to young adults whose parents have private health insurance, varying interpretations of the provision by states have effectively blocked these youth formerly in foster care from accessing their federally mandated coverage.

An estimated 180,000 young people who have aged out of the foster care system are eligible for extended health care coverage.  However, only 13 states have made Medicaid coverage available to all former foster youth who reside in their state, regardless of the state in which they aged out.

The policy brief provides an overview of the health needs of young people in and aging out of foster care; describes the coverage to be provided to former foster youth via the ACA, the restrictions that have been applied, and the major reason for opposition to coverage; and makes recommendations to legislators and states for removing barriers to access.  The brief also highlights the need to ensure that young people have the knowledge and skills to use their health care coverage.