Avanti Alias, a 23-year-old former foster youth, works part-time while also attending business school full-time to pursue an MBA. Avanti struggles with depression, and coverage under Medi-Cal (California’s Medicaid) allows her to see a therapist when she is feeling low. She says that Medi-Cal is critical for former foster youth. “It puts us in a better health position today and in the long term,” she says. “Health affects everything from work, to school, to every aspect of your life. Many people have health coverage, but we [former foster youth] don’t always have supports like this. No one is there to help us with this stuff. This law gives us that protection, which is something we’ve never had before.”
There is overwhelming support in California and nationwide to ensure health coverage is available to young adults until they’re 26 through a parent’s health insurance. A less well-known but vital provision of the Affordable Care Act (ACA) provides former foster youth with that same right to coverage by making youth who have aged out of foster care eligible for Medicaid (known as Medi-Cal in California) until age 26. More than 18,000 former foster youth in California currently benefit from this coverage, and nationwide 74,000 former foster youth are projected to be enrolled in 2017.
The reasons children enter foster care are never good. From the moment they enter the system, California has the legal and moral obligation to protect children who have experienced abuse or neglect at the hands of adults. Sometimes it’s physical or sexual abuse. Some were born exposed to drugs. Others have lived in homes where a parent struggled with significant mental health or substance abuse problems, or they witnessed severe domestic violence. Being removed from one’s family is itself a traumatic experience. Because of childhood abuse, neglect, and trauma, foster youth have high rates of acute and chronic medical, developmental, and behavioral health issues that often persist into adulthood. This makes consistent access to health care essential for them to heal and thrive.
Each year in California, up to 5,500 youth exit foster care at 18 or older, an event known as “aging out.” Nationwide more than 20,000 youth age out each year. These youth often lack the support they need to successfully navigate the transition to adulthood. Unlike their peers, many former foster youth can’t count on the emotional or financial support of a caring adult or family member. This puts them at greater risk for a variety of problems, such as unemployment, homelessness, and incarceration.
Like a parent, the state must ensure that foster children receive the support and services they need to become successful young adults, including having access to health coverage. Continuous coverage allows former foster youth to get regular and preventive care, helping them to achieve self-sufficiency and lead healthy, productive lives, and thrive.
Alexis Barries, a 23-year-old former foster youth, was born with severe asthma. For her, the Medi-Cal program is the lifeline to health care that allows her to breathe easier. Alexis aged out of foster care at 21 and currently works two part-time jobs, commuting to Sacramento daily from Stockton. In her home, Alexis has a breathing machine that helps her control her asthma, as well as inhalers that she carries with her. Even so, two or three times a year she ends up in the emergency room due to asthma attacks triggered by things as simple as changes in weather or the seasons.
Without Medi-Cal coverage until age 26, many young people like Alexis and Avanti would be uninsured, resulting in more emergency room visits and higher costs to them and their communities, not to mention the emotional toll they would experience. Protecting health care for our most vulnerable youth is fair, cost-effective to society, and unquestionably the right thing to do.
Children Now has worked on this issue extensively. We closely monitored the debate over the unsuccessful ACA repeal bill in the House of Representatives and will respond quickly to administrative and budgetary threats that could hurt the health of former foster youth. It is imperative that we maintain the gains achieved under the ACA by keeping former foster youth eligible for Medicaid until age 26. More broadly, federal health policies must support a strong and stable Medicaid program capable of meeting the health care needs of some of the most vulnerable Americans. Otherwise, former foster youth — like millions of low-income children, seniors, and persons with disabilities — will suffer.
Ted Lempert is the president of Children Now, an Oakland-based national research and advocacy organization dedicated to promoting children’s health, education, and well-being. He is also a lecturer in the political science department at the University of California, Berkeley. Previously, he was the founding CEO of EdVoice, and served for eight years as a California State Assemblymember representing San Mateo and Santa Clara Counties.