Voices’ Blog

Medicaid Eligibility for “Aging Out” Youth

Posted:  -  By: Voices for VA's Kids

Currently in Virginia, under the Affordable Care Act (ACA), children who “age out” of the Commonwealth’s foster care system at age 18 are eligible for Medicaid until age 26 based on their status as former foster youth, mirroring the “parental/private insurance” provision available to other youth. The ACA, however, leaves up to state option whether to provide this same eligibility to youth living in Virginia who “aged out” of another state’s foster care system. Because of this, these vulnerable youth, who are more likely to have health issues and less likely to have health insurance or seek health or mental health treatment, may not have access to adequate healthcare.

The federal government allows states to grant Medicaid-to-Age-26 eligibility to youth who have “aged out” of any state’s foster care system, but Virginia must opt in to this provision in order to do so. Virginia *should* choose to extend this eligibility to any youth who has “aged out” of care, regardless of their state of origin. Some points to consider:

  • Youth who “age out” of foster care at age 18, no matter in which state, are extremely vulnerable to outcomes such as: unemployment, homelessness, increased health issues, and teen/early pregnancy. These are youth who have not been connected to permanent family and often must navigate the transition to adulthood on their own.
  • Youth who “age out” of another state’s foster care system and come to Virginia do not have access to any other services currently available to youth who “age out” of our own foster care system, which are designed to help avoid these negative outcomes.
  • Youth who “age out” of foster care but have no access to services—compared to their peers who do—are less likely to have health insurance and less likely to seek treatment for both physical and mental health issues. (Chapin Hall, Midwest Study)
  • The Jim Casey Foundation estimates “the cost of doing nothing” for youth who “age out” of foster care at approximately $300,000 per youth in community costs, additional public welfare payments, lost tax revenue and criminal justice costs. Extending one critical service—health care—to these youth, would avoid some of these state and taxpayer-funded expenses.
  • Of the states who have already agreed to opt-in to providing Medicaid eligibility to age 26 for youth who “age out” of any state’s foster care system, several are in close proximity to Virginia: Kentucky, New York, Maryland and Pennsylvania (in addition to California).
  • $91,000/year will provide coverage for 25 youth per year.

Additionally, if Virginia were to be one of the states taking the lead in helping all children who age out of foster care to gain health care access, regardless of their state of origin, we could help spur this change in other states–there will be a “domino effect” of reciprocity from other states who initially may have been reluctant to extend this option.

These amendments will be considered by both the House and the Senate as they put together their final budget bills for approval by the legislature. Stay tuned — we may be sending out Action Alerts to help you all contact the Senate Finance and House Appropriations committee members to encourage them to support this effort.

You can find a one-pager/fact sheet in support of Senator Howell’s version of this budget amendment here (pdf).

You can find a one-pager/fact sheet in support of Delegate McClellan’s version of this budget amendment here (pdf).

We will need support of both of these amendments to make sure identical versions appear in both the Senate and House budget bills, to give the effort the best chance of survival in the final approved budget.

For any questions or feedback on this issue, please contact Voices Senior Policy Attorney Amy Woolard at amy@vakids.org.

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