As we have previously noted, the Affordable Care Act (ACA) contains a key provision for youth aging out of foster care – under the law, states are required to provide Medicaid health insurance coverage for youth who were in foster care in their state, up until age 26. This policy mirrors the ability of youth not in foster care to stay on their parent’s health insurance until the same age. Pennsylvania even goes a step further and provides this coverage to young adults who aged out of foster care in another state.
Recent proposals by Congress and President-elect Trump to repeal the ACA and convert Medicaid into a block grant would strip this right from youth who are already at risk of experiencing various negative adult outcomes. Research shows that youth who age out of foster care are at greater risk of unemployment and homelessness than their peers who don’t experience foster care. Continued health coverage protects these same young adults from these risks.
Further, while a block grant may sound like a simpler way to fund the Medicaid program, this action risks destabilizing state budgets. A capped federal payment for these services doesn’t take into account the flexibility required should we face another recession, or the increase in health care needs of an aging baby boomer generation. States may find themselves cutting costs that hurt children and youth the most – such as prevention and other nonprofit children and family services – or freezing state staff hiring when these positions are vital to the health and well-being of children in state care, when faced with budget cuts in order to meet any unexpected increased need.
Child welfare agencies have long relied on Medicaid coverage for youth in foster care, and some states, including Pennsylvania, have expanded the program to cover low-income adults. Birth parents who receive substance abuse, mental health and other medical services as they work to provide a safe and stable home for their children are one group who is now served through this program.
Repealing the ACA without a sustainable replacement plan in place would double the number of uninsured children, and remove a vital service to one of our nations’ most vulnerable populations.
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