Georgia Association of Homes and Services for Children

Expansion of Medicaid Eligibility For Georgia’s Foster Youth 
July 15, 2002
Prepared by Angela Tanzella, GA CASA

In 1999, President Clinton signed the Foster Care Independence Act (FCIA) into law (P.L. 106-169).  The FCIA provides significant assistance to youth transitioning from foster care upon emancipating or “aging out” of the system.  It establishes the John H. Chafee Foster Care Independence Program (Chafee Program), which allows states to extend Medicaid coverage to youth between the ages of 18 and 21 who were in foster care on their eighteenth birthdays. 

            Most foster children have physical and mental health care coverage through Medicaid while in care.  Problems occur when they exit the system and coverage eligibility terminates.  Too often, youth leaving foster care exit without access to health care because many obtain full-time jobs that neither provide health insurance nor pay a salary that is sufficient to allow the youth to purchase it on their own.  This lack of health insurance is one of the most unfortunate, inadvertent consequences that accompanies the transition from foster care into adulthood. 

The Chafee Program offers a solution to this disheartening problem.  States may extend Medicaid coverage to all foster youth between the ages of 18 and 21, or they may restrict this group by income or other reasonable categories.  Federal funding is guaranteed; however, states must provide matching funds that are the same as for other parts of the Medicaid program.  In Georgia, the federal participation rate is 59.60% - thus the state would only have to bear just over 40% of the cost. 

            Under the Chafee Program, nine states have already expanded Medicaid eligibility to foster youth, through legislative and administrative means.[1]  Arizona, California, Mississippi, New Jersey, Oklahoma and Texas recognized their foster youths’ inaccessibility to medical care and passed laws to expand Medicaid eligibility.  Hawaii, South Carolina, and Wyoming have administratively tackled this issue by implementing policies through their state agencies equivalent to Georgia’s Department of Family and Children Services.  These states were able to fund the Medicaid extension either by appropriating additional funding in their state budgets or by utilizing existing funds. 

            All of the states that were successful in implementing the Medicaid extension had complete support for this endeavor.  Governors and state leaders, legislators, child protective service agencies, numerous child advocacy organizations, and of course, the foster youth themselves all supported this expansion.  The foster youths’ testimonies were probably the single most important component to the implementation.  Georgia’s Youth Leadership Council has identified the extension of Medicaid eligibility as one of its top legislative priorities and will advocate for its expansion.

            In Georgia, current foster youth receive funds from the Department of Family and Children Services (DFCS) to cover their health insurance.  After age 18, unless the youth have signed themselves back into the system, the youth are emancipated, and they subsequently lose their Medicaid benefits.  If a youth has signed himself back into state custody, he will continue to receive Medicaid, but only until age 19.  Although many average 18 year olds are still covered under their parents’ health insurance policies at this age and are dependent upon them until their mid-20s, foster youth do not have this luxury.  Instead, they are released into the world, many of them unprepared to be self-sufficient. 

            Expanding Medicaid eligibility to foster youth age 18-21 would be a way of helping youth to keep their jobs and ultimately be productive citizens.  The availability of health care could mean one less burden for the youth to carry with while finding employment.

            A means of providing medical assistance to foster youth is necessary.  Georgia can help alleviate this heavy financial burden by working toward a plan to grant these youth Medicaid benefits.  Because FCIA mandates that federal funding will be provided, Georgia only needs to contribute a state match of 40% of the dollars required to extend coverage.  With such possibilities available, it would be unfortunate to allow this opportunity to pass us by.  In addition, with only nine states currently extending Medicaid to emancipated youth, Georgia possesses a unique opportunity to be on the national forefront in providing basic health care coverage to its own children.