Juvenile Law Center

Access to Healthcare|Coveredtil26 (Health Insurance)|Child Welfare and Foster Care

Access to Healthcare

Foster youth confront significant health issues and require continued treatment once they age out of the system. Yet, they typically lack health insurance when they leave care either because they do not have jobs that provide insurance or they do not meet the eligibility criteria for Medicaid.

More than 50% of former foster youth report being uninsured, and more than 20% report unmet medical needs.1 The Midwest Study found that in the past year: 33% of youth aging out reported two or more emergency room visits; 22% were hospitalized at least once; 43% were uninsured; fewer than 50% had dental insurance; 75% of the young women had been pregnant; and 19% received behavioral health services.2

The Affordable Care Act (ACA) improves access to health insurance and health care for youth aging out of foster care. Effective January 2014, youth who were in foster care at age 18 and who were enrolled in Medicaid at that time became categorically eligible for Medicaid until age 26, regardless of their income. This provision is intended to mirror the ACA’s requirement that allows young adults to stay on their parents’ health insurance until age 26, if necessary. The ACA will help ensure that former foster youths’ treatment needs are met.

With the ACA is in place, implementation is a priority. Juvenile Law Center works to improve health insurance coverage for former foster youth by:

  • Improving state level implementation of the ACA provision by promoting streamlined, user-friendly procedures for eligibility, application, and renewal;
  • Increasing awareness of the provision; and
  • Advocating that federal policy require that all states cover former foster youth irrespective of what state they lived in when they aged out of care. 


More resources:


1 Kushel, M. B., Yen, I. H., Gee, L., & Courtney, M. E. (2007). Homelessness and health care access after emancipation: results from the Midwest Evaluation of Adult Functioning of Former Foster Youth. Archives of pediatrics & adolescent medicine, 161(10), 986-993.
2 Courtney, M.E., Dworsky, A., Lee, J.S., Raap, M. (2010). Midwest Evaluation of the Adult Functioning of Former Foster Youth: Outcomes at Ages 23 and 24. Chapin Hall at the University of Chicago.


Last updated: 2/10/2015

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