Mandatory Medicaid coverage for former foster care youth who have aged out of the foster care system but are in care as of their eighteenth birthday—an important provision in the Affordable Care Act (ACA) that isn’t as widely known as it should be—is finally getting some traction thanks to a recent paper in the Michigan Journal of Social Work and Social Welfare.

Finding quality, affordable health insurance can often be difficult for youth transitioning out of the foster care system, and providing Medicaid coverage as a bridge during this pivotal time up to age 26 is an incredibly significant step forward. According to the paper’s author, Aisha Hunter (having herself aged out of the foster care system), “the 2014 foster youth health care expansion plan represents the most comprehensive and profound legislation for this population in decades.” Here at Community Catalyst’s New England Alliance for Children’s Health program, we couldn’t have said it better ourselves.

The foster youth expansion provision goes into effect beginning in 2014. It builds  upon the Foster Care Independence Act of 1999, which, among other things, gave states the option of extending Medicaid coverage to foster youth up to age 21 through the John Chafee Foster Care Independence Program (otherwise known as the “Chafee option”).

The paper also helpfully points out that, despite the difference  this ACA provision will make in the lives of youth aging out of the foster care system, there are important implementation issues that need to be addressed to make it as effective as possible. For instance, because all foster youth aging out of Medicaid will qualify for the program up to age 26, individual applications for enrollment are an unnecessary burden for the youth themselves as well as for parents and child welfare workers. Instead, an automatic enrollment process should be put into place to ensure these youth can easily take advantage of this important ACA benefit. Additionally, in order to ensure continuous health insurance coverage during this transitional period for youth, states should not be permitted to deny youth’s access to Medicaid simply because they have another potential source of coverage.

The extension of Medicaid coverage to youth aging out of the foster care system is another example of how the ACA is full of commonsense reforms that enhance access to care for those who need it most. When we hear overblown rhetoric about this historic law, it’s worth remembering that it’s already helping real people every day, and will help even more as time goes on.

—Patrick M. Tigue, Senior Policy Analyst