Access to Healthcare

We believe all young people have a right to comprehensive, high-quality healthcare. The child welfare and justice systems must ensure that youth in their care receive full and coordinated physical and behavioral health services, and that healthcare coverage continues when youth leave these systems.

Healthcare Crisis For Youth

Youth in the child welfare and justice systems too often have unmet physical, developmental, and mental health needs. Multiple studies have found that youth with system involvement experience certain serious health conditions — including physical and mental disabilities, as well as Post Traumatic Stress Disorder (PTSD) — at much higher rates than the general population. High-quality healthcare is critical to healthy growth and development.

In 2004, more than 50% of former foster youth reported being uninsured, and more than 20% reported having untreated medical needs. The number of youth surveyed in 2018 who reported having health coverage grew to over 90% thanks to the passage of the Affordable Care Act, but many barriers remain (for example, in 2018, 14% of youth in foster care still reported untreated medical needs). A 2010 study found that 33% of youth “aging out” of foster care reported two or more emergency room visits. The same study also found that 22% of youth in foster care were hospitalized at least once; 43% were uninsured; fewer than 50% had dental insurance; 75% of the young women had been pregnant; and only 19% received behavioral health services.

Looking Ahead: The Affordable Care Act and Beyond

As noted, effective January 2014, a change in federal law increased Medicaid coverage for youth in foster care. Under the new law, youth who were in foster care and enrolled in Medicaid at age 18 became eligible for Medicaid until age 26. This important reform helped to level the playing field for foster youth, since the Affordable Care Act (ACA) also allows young adults to stay on their parents’ health insurance until age 26.

The ACA’s “Medicaid to 26” provision has helped ensure that former foster youths’ health needs are met. However, implementation challenges remain for youth in the foster care system. For example, when youth move from one state to another after leaving care, some states fail to provide youth with Medicaid coverage. Youth in the juvenile justice system also face significant challenges in gaining access to health care.  Proposed changes to Medicaid threaten to narrow coverage still further for vulnerable youth. 

Juvenile Law Center works to improve health insurance coverage for youth in the child welfare and justice systems, including youth who “age out” of foster care and youth exiting the juvenile justice system. We also hold systems accountable to provide support and treatment — rather than impose harm and punishment — for youth with histories of trauma. Youth deserve to be treated with dignity and respect, and with the healthcare they need to thrive.

Medicaid to 26 for Former Foster Youth

The Affordable Care Act (ACA) provides Medicaid until age 26 for former foster youth who were enrolled in Medicaid when they turned 18 or aged out of care. It's free! You pay $0 for your insurance. After you leave care, you may have to cover some small co-pays, but you do not have to purchase insurance or pay premiums.