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  • Do you know a young adult who has taken advantage of the President’s Affordable Care Act (ACA) provision that allows young people to stay on their parent’s health plan until they are 26 years old? In this age of underemployment, lots of new high school and college graduates are grateful (and so are their parents) for that benefit. Now, imagine what happens to young adults who have spent their teenage years in foster care, with the state as their parent. When they reach 18-21, they leave foster care and its benefits and must find a job, a home, and their place in the world. Fortunately, thanks to the ACA, they now have access to health-care coverage similar to that of other young adults.

    In fact, one of the most important developments to come out of the President’s Affordable Care Act for the child welfare field is a small but significant provision that allows youth in foster care on their 18th birthday to continue their Medicaid coverage until age 26. Before the ACA, youth who “aged out” of foster care often had limited or no options to continue health-care coverage into young adulthood. This provision became effective in January of this year, and it means that the approximately 23,000 young adults who will exit foster care this year with no permanent family will still be able to count on Medicaid for health coverage until they turn 26.

    This is especially important given the higher rates of physical and mental health issues that many youth in foster care experience. Children and youth usually enter foster care because of child abuse, neglect, and other traumatic experiences. This can lead to greater medical and mental health care issues and may also have long-term health consequences. Thus, young adults who age out of foster care when they are 18-21 years old may have a significant need for reliable health care—and now they are eligible for it. An additional benefit of the ACA is its emphasis on integrated care for those with chronic conditions. This focus on well-coordinated services may be especially advantageous to those in and leaving foster care.

    If you are a foster parent or know teens in foster care or previously in care, you can help ensure that eligible youth maintain their health-care coverage. This benefit applies to all young adults who are not yet 26 and who were in foster care and receiving Medicaid when they aged out of foster care in their state; so, even many of those 21-25 year olds who lost coverage for a few years can now enroll. In addition, if you are a service provider—for instance, a therapist, substance abuse treatment provider, criminal justice provider, etc.—who works with older youth in or formerly in foster care, find out how this new ACA provision may benefit your clients.

    At the Children’s Bureau, we have a long history—more than 100 years—of advocating for children and youth and their families. In recent years, one of the Bureau’s key goals has been to safeguard the well-being of children and youth involved with the child welfare system. Ensuring that our older youth and young adults have access to necessary health care is just one of the many ways to contribute to their well-being.

    To learn more about Medicaid and CHIP and how to enroll, visit your state’s Medicaid agency or Or call 1-877-KIDS-NOW (1-877-543-7669).

    JooYeun Chang, J.D., is Associate Commissioner of the Children’s Bureau, Administration for Children & Families, U.S. Department of Health and Human Services. Contact:


    For more information about

    ·         Foster care statistics:

    ·         FAQs regarding Medicaid and youth exiting foster care:

    ·         Health-care needs of children and youth in foster care:

    ·         The Children’s Bureau:

    Child welfare:

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