For Former Foster Kids, Moving Out of State Can Mean Losing Medicaid


By Anna Gorman , Kaiser Health News


Soon after moving to Utah this summer, Rainbow Sky Buck ended up at the hospital with a painful ear

infection. There, Buck learned she no longer had access to the free health coverage she had in California as


a former foster youth.


To pay for the care, Buck emptied out her bank account and borrowed money. “Luckily, I got my

antibiotics and I am okay now,” she said. “But what is going to happen next time?”


Under the health law, young adults who age of out of the foster care system are eligible for free Medicaid

coverage until they turn 26. The provision was an attempt to give them the same opportunity as other young people who can stay on their parents’ insurance until their 26th birthday.


But these young adults are encountering a major barrier: They are only guaranteed coverage in the state

where they were in foster care. States have the option of extending the benefit to all former foster youths,

but only about a dozen have done so.


Now, advocates and policymakers are trying to change the law at the federal level, so former foster youths

don’t lose access to Medicaid coverage no matter where they move.


Reps. Karen Bass, D-Calif., and Jim McDermott, D-Wash., have proposed legislation that would allow

them to qualify for Medicaid, the government health program for low-income Americans, in any state.


Sen. Bob Casey, D-Pa., has introduced a similar bill that he said would be a simple clarification of what

Congress intended. Meanwhile, advocates are pushing the Centers for Medicare & Medicaid Services to

change its interpretation of the original provision.


First Focus, which advocates for foster youths, has been receiving calls from young people who had no idea

that they would lose health insurance when they moved.


“We really do feel an urgency about this,” said Shadi Houshyar, vice president of child welfare policy at

the organization. “So many people who have aged out have significant health needs and coverage is so

important. There shouldn’t be an additional barrier.”


Former foster youths are more likely than their peers to have physical and mental health needs, experts say.


Ongoing research in Illinois, Wisconsin and Iowa shows that 22 percent of former foster youths had been

hospitalized at least once in the previous year and one-third had two or more emergency room visits.


Just like other young people, former foster youths move to different states for school, jobs or family, said

Fatima Morales, policy and outreach associate for the advocacy group Children Now. Morales said they

shouldn’t be penalized for doing so.


Morales said her organization is trying to inform youths what they might face if they move. “They need to

know how their health coverage might be impacted,” she said. “It’s just something that they need to weigh.”


Lezlie Martinez, 19, is weighing her options now. She is hoping to move from California to Colorado

because she wants to live in a place with a lower cost of living. Her boyfriend is already there and she is

looking for hospitality jobs to support herself and her 2-year-old son.


But she worries that she may be left uninsured and unable to pay for medical treatment for eczema,

allergies and fibromyalgia. “It is causing foster youth to be stuck in the same state they were raised in,” said

Martinez, who lives in Oceanside, Calif. “It is really stressing me out.”


Buck said she decided to move to Sandy City, Utah, because of the limited job prospects in the small

northern California town of Crescent City. Before moving, she asked social workers about whether she

would still qualify for free health coverage and was told that she would. Buck said she was shocked to learn



She is no longer seeing a therapist for depression and said she is weaning herself off antidepressants

because she can’t afford them. Buck said she also worries about getting another ear infection and not being

able to afford treatment.


“It is just scary to think I am completely on my own,” said Buck, who recently got a job at an automotive

shop but doesn’t get insurance from her employer. “I don’t want to leave, but this is almost forcing me to

move back to California.”


Kaiser Health News can be reached at


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