Nav: Home

Young people aging out of foster care may be leaving behind critical healthcare coverage

October 17, 2016

NEW YORK, October 18, 2016 -- States are required to provide health insurance to young people who have aged out of the foster care system until their 26th birthday. Although the intent of the provision is to mirror the extended coverage available to young adults whose parents have private health insurance, research at the National Center for Children in Poverty (NCCP), Columbia University Mailman School of Public Health, shows that varying interpretations of the provision by states have effectively blocked many youth formerly in foster care from accessing their federally mandated coverage. The new report is titled: Fostering Health: The Affordable Care Act, Medicaid, and Youth Transitioning from Foster Care.

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.

"It's encouraging that some states have been trailblazers in promoting the health of children while they're in foster care -- from ensuring health care access and coordination through electronic health care passports to establishing data-sharing requirements," said NCCP director Renée Wilson-Simmons, DrPH, who is also assistant professor of Health Policy and Management at the Mailman School and report co-author. "However, several states are undoing that good work once young people leave the system, just because they aged out in another state."

Under the ACA, young people who were in foster care and enrolled in Medicaid on their 18th birthday -- or older in states that extend foster care beyond age 18 -- are eligible for Medicaid until age 26, regardless of their income. Despite this seemingly straightforward provision, some states have denied coverage based on an interpretation of the provision's wording that defines eligible youth as those who had been in the custody of "the state" rather than "a state." Those states have taken that distinction to mean that the ACA mandates that states extend Medicaid coverage to young people who were in that state's custody when they aged out of care ("the state"), and not to young people who were in the custody of another state ("a state").

The report also found that while states have identified cost as the major barrier to a more inclusive interpretation of the ACA provision, denying Medicaid coverage to former foster youth may actually cost states more money in the long run. Costs to provide health care to the poor have risen twice as fast as In states that declined to expand Medicaid eligibility as part of the ACA compared to those that extended benefits to more low-income residents -- 7 percent versus 3 percent. The report suggests that the 37 states that have not provided Medicaid coverage to young people who exited foster care from other states will likely incur even higher medical costs as well, particularly if these young people delay seeking needed medical care and wind up in an emergency room.

"No child who's seeking an education, pursuing a job opportunity, or attempting to start the next phase of life in a different state should lose health coverage," added Wilson-Simmons. "But many former foster youth are being forced to do just that."

To better support the health needs of those who have transitioned from foster care, the report calls for removing the hurdles over which these young people must jump to get the care to which they are entitled, whether they choose to remain in their "home state" after aging out or not. The center's recommendations included streamlining the process for applying for health coverage and using more creative means to inform foster youth of their eligibility and how to enroll.
About the National Center for Children in Poverty (NCCP)

The National Center for Children in Poverty (NCCP) is a nonpartisan public policy research center dedicated to promoting the economic security, healthy development, and well-being of America's low-income children and their families. Part of Columbia University's Mailman School of Public Health, NCCP uses research to inform policy and practice with the goal of ensuring positive outcomes for our nation's children. For more information on the National Center for Children in Poverty, visit Like us on Facebook or follow us on Twitter via @NCCP.

About Columbia University's Mailman School of Public Health

Founded in 1922, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including ICAP (formerly the International Center for AIDS Care and Treatment Programs) and the Center for Infection and Immunity. For more information, please visit

Columbia University's Mailman School of Public Health

Related Public Health Articles:

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.
Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.
Bloomberg American Health Initiative releases special public health reports supplement
With US life expectancy now on the decline for two consecutive years, the Bloomberg American Health Initiative is releasing a supplement to Public Health Reports, the scholarly journal of the US Surgeon General.
Data does the heavy lifting: Encouraging new public health approaches to promote the health benefits of muscle-strengthening exercise (MSE)
According to a new study in the American Journal of Preventive Medicine, almost 75 percent of US adults do not comply with public health guidelines recommending two or more muscle-strengthening exercise (MSE) sessions a week, with nearly 60 percent of the population doing no MSE at all.
The Lancet Public Health: Moderate carbohydrate intake may be best for health
Low-carb diets that replace carbohydrates with proteins and fats from plant sources associated with lower risk of mortality compared to those that replace carbohydrates with proteins and fat from animal sources.
Mass. public safety, public health agencies collaborate to address the opioid epidemic
A new study shows that public health and public safety agencies established local, collaborative programs in Massachusetts to connect overdose survivors and their personal networks with addiction treatment, harm reduction, and other community support services following a non-fatal overdose.
Cyber attacks can threaten public health
Gordon and Landman have authored a Perspective piece in the New England Journal of Medicine that addresses the growing threat of attacks on information systems and the potential implications on public health.
Public health guidelines aim to lower health risks of cannabis use
Canada's Lower-Risk Cannabis Use Guidelines, released today with the endorsement of key medical and public health organizations, provide 10 science-based recommendations to enable cannabis users to reduce their health risks.
Study clusters health behavior groups to broaden public health interventions
A new study led by a University of Kansas researcher has used national health statistics and identified how to cluster seven health behavior groups based on smoking status, alcohol use, physical activity, physician visits and flu vaccination are associated with mortality.
Public health experts celebrate 30 years of CDC's prevention research solutions for communities with health disparities
It has been 30 years since CDC created the Prevention Research Centers (PRC) Program, currently a network of 26 academic institutions across the US dedicated to moving new discoveries into the communities that need them.
More Public Health News and Public Health Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

In & Out Of Love
We think of love as a mysterious, unknowable force. Something that happens to us. But what if we could control it? This hour, TED speakers on whether we can decide to fall in — and out of — love. Guests include writer Mandy Len Catron, biological anthropologist Helen Fisher, musician Dessa, One Love CEO Katie Hood, and psychologist Guy Winch.
Now Playing: Science for the People

#542 Climate Doomsday
Have you heard? Climate change. We did it. And it's bad. It's going to be worse. We are already suffering the effects of it in many ways. How should we TALK about the dangers we are facing, though? Should we get people good and scared? Or give them hope? Or both? Host Bethany Brookshire talks with David Wallace-Wells and Sheril Kirschenbaum to find out. This episode is hosted by Bethany Brookshire, science writer from Science News. Related links: Why Climate Disasters Might Not Boost Public Engagement on Climate Change on The New York Times by Andrew Revkin The other kind...
Now Playing: Radiolab

Breaking Bongo
Deep fake videos have the potential to make it impossible to sort fact from fiction. And some have argued that this blackhole of doubt will eventually send truth itself into a death spiral. But a series of recent events in the small African nation of Gabon suggest it's already happening.  Today, we follow a ragtag group of freedom fighters as they troll Gabon's president - Ali Bongo - from afar. Using tweets, videos and the uncertainty they can carry, these insurgents test the limits of using truth to create political change and, confusingly, force us to ask: Can fake news be used for good? This episode was reported and produced by Simon Adler. Support Radiolab today at