POLICY SOLUTIONS TO ADDRESS THE BARRIERS TO MEDICAID RE-ENROLLMENT FOR YOUTH AGING OUT OF FOSTER CARE

Abstract

EXECUTIVE SUMMARY POLICY QUESTION What are the Federal and State policy solutions to the barriers for youth re-enrolling into Medicaid once they have left care? RECOMMENDATIONS I recommend three solutions that the Children’s Bureau should consider to address the barriers of Medicaid re-enrollment for youth aging out of foster care. The Children’s Bureau should: • Support states in making the transitions onto Medicaid after foster care a seamless process. • Encourage restructuring of the independent living programs. • Study the possibility of a change in institutional mechanisms. IDENTIFIED ISSUES Nationally about 30,000 of the half million youth in state custody will age out of care this year . Youth aging out of care are at greater risk of unemployment, homelessness, dropping out of school, and unplanned parenthood . These transition age youth report more health problems and mental health diagnoses, than their peers who have not been in the child welfare system . Unfortunately many recently emancipated young adults do not have health insurance; this makes swift and appropriate interventions much harder to achieve. I have identified four barriers to youth re-enrolling into Medicaid once they have left care. First, there is a lack of knowledge at the service delivery level, for both Medicaid enrollment staff as well as independent living coordinators. This is likely due to high turnover amongst staff in both divisions. Second, for youth that have aged out of care there is a lack of knowledge of the Medicaid option. There is variability in how independent living programs are delivered and some states and counties may not have a set curriculum for teaching transition age youth about their benefits. Third, once youth have left foster care they have shown a strong desire to disassociate with “the system”. Lastly, youth who have aged out of foster care lack healthy adult connections. These are adults that many transition age youth can turn to help them understand their insurance or how to make a doctor’s appointment. Former foster youth often do not have a parent or other supportive adult they can turn to for help. CRITERIA I use the following criteria to analyze my solutions: • Minimize costs for key stakeholders. • Create collaborations among stakeholders. • Assist states in their preparation for providing health insurance for all youth that age out of care until age 26. POLICY SOLUTIONS The five policy solutions I evaluate are:

Support states in making the transition onto Medicaid after foster care a seamless process.

Encourage restructuring of the independent living programs.

Study the possibility of a change in institutional mechanisms.

Support collaborations with service providers outside of DSS.

Encourage states to develop websites that clearly communicate eligibility benefits for stakeholders.