Outreach Is Key On New Medicaid Guarantees for Aged-Out Foster Youth

The below is reproduced from the Chronicle of Social Change with the permission of Fostering Media Connections. It was originally published here.

Don’t take me to the hospital. Don’t take me to the hospital!”

That’s all Joel Urzua could think about when the police officer asked if he needed medical assistance. Uruza had just been rear-ended hard by a drunk driver on a Los Angeles freeway.

Uruza (pictured below right) was so disoriented he couldn’t remember his last name, but he could remember one thing… he didn’t have health insurance, and costly hospital bills could ruin him.

“I lied and told them I was fine,” Uruza said. Uruza is a former foster youth who emancipated from the foster care system and lost his medical coverage.

What Uruza didn’t know was that the Affordable Care Act, which went into effect January 1, 2014, included a provision that requires states to provide medical coverage to former foster youth who exited foster care at age 18 or older but are still under the age of 26. This special provision grants foster youth the same coverage allowance as other young adults who stay on a parent’s insurance plan until the same age.

Youth emancipating from foster care must be automatically enrolled in Medicaid coverage. Uruza falls into a unique “gap” group of foster youth who left foster care prior to the new law, lost coverage and is now eligible to re-enroll because he is under 26.

Through an astonishing stroke of luck, a few weeks later Uruza received an email about his medical coverage eligibility, registered and was able to take care of his injuries. Absent that, he might still be suffering in silence.

Tracking former foster youth can be a challenge, and many still do not realize they are eligible for coverage. Every year it is estimated that 20,000 annually “age out” of foster care across the United States.

Uruza’s home state of California is one of a few states that extend coverage to any state resident who exited foster care at age 18 or older, regardless of the state the youth was in foster care. At the moment, the federal Department of Health and Human Services does not require states to enroll youths who were in a different state’s foster care system.

To reach this special “gap” group, California child policy, research and advocacy organization Children Now launched the “Covered ‘Til 26” campaign—an aggressive outreach program dedicated to educating young adults, organizations and county agencies about former foster youths’ coverage eligibility.

Funded by The California Wellness Foundation through year-end 2016, Children Now runs a youth-friendly website (Coveredtil26.org) on how former foster youth can retain or enroll in Medi-Cal. The group even provides individual guidance for those struggling with the process.

“Former foster youth are a vulnerable group that too often lacks adequate support to navigate the transition to adulthood successfully,” said Fatima Morales, Policy and Outreach Associate at Children Now. “They are much less likely than their peers to have health insurance but they tend to have more health care needs due to abuse, neglect or trauma experienced during childhood.”

Like the Affordable Care Act, the Medi-Cal extension to age 26 for former foster youth has had its kinks.

“The health care registration systems weren’t programmed to appropriately enroll former foster youth in the Medi-Cal program,” Morales said. “So some former foster youth who are eligible have received incorrect eligibility determinations. Children Now has worked aggressively with advocates to raise awareness of these technical issues with state and county agencies, stakeholders and even the media to ensure these fixes are a priority.”

Oscar Sanchez falls into the “gap” group. He and his three siblings entered foster care after their single mother left home to run an errand and never returned. Sanchez, who now works and attends college in San Diego, struggled with the Medi-Cal registration process.

An avid cyclist, he broke his clavicle and several ribs after hitting a pothole while training for a bike race. In the emergency room he learned that he had registered incorrectly, so all he could get was a sling and some pain killers to avoid paying out of pocket.

“I contacted Covered ‘Til 26 and Fatima helped me fix my health care coverage,” Sanchez said. “It was pretty hectic at first, but after completing a one-page document I’m covered, have gotten better care and I see an Orthopedist for my injuries.”

Erica Ontiveros (pictured left) of Orange County wasn’t taught proper dental hygiene as a child in foster care; as a result she had a mouth full of painful cavities. Medi-Cal coverage allowed Ontiveros to visit a dentist for treatment. Had she waited much longer to treat the cavities, Ontiveros would have required much more invasive root canal procedures.

“I’m really grateful for Medi-Cal. It has been a turning point for my health,” acknowledged Ontiveros.

To date, the Covered ‘Til 26 campaign has connected approximately 6,500 former foster youth to information and resources about extended Medi-Cal coverage and how to enroll in or retain coverage. Children Now has partnered with foster care alumni groups, community groups, direct service providers, news organizations and California legislators to help spread the word to current and former foster youth.

Former foster youth living in California who have questions or wish to sign up for Medi-Cal should visit Coveredtil26.org. Former foster youth living in other states should click here to find registration details for their state.

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