Many children exiting foster care are not receiving needed medical attention due to a lack of health care coverage, according to a recent report by the Kaiser Commission on Medicaid and the Uninsured. Although many children who leave foster care through reunification and adoption are eligible for some type of health insurance, the steps necessary to retain existing coverage or obtain new coverage can be complex. The report, Children Discharged from Foster Care: Strategies to Prevent the Loss of Health Coverage at a Critical Transition, indicates families sometimes find the process overwhelming and allow the child's insurance to lapse.

States are likely to end up bearing some of the financial burden of uninsured children using urgent or emergency medical services. Therefore, the Kaiser Commission suggests a number of steps States and child welfare agencies can take to help this vulnerable population maintain health care coverage when they transition out of foster care. These include:

* Providing 12 months of continuous coverage to all children enrolled in Medicaid, regardless of changes in family income, assets, or other circumstances.
* Using information in Medicaid files or from other benefit programs to renew eligibility.
* Providing families with extended "grace periods" to obtain required documents and complete paperwork.
* Monitoring loss of coverage at foster care discharge through an alternative case action review.
* Facilitating information exchange between child welfare agencies and those responsible for enrollment in State Children's Health Insurance Program (SCHIP) coverage.
* Developing official Medicaid notices that are easy to read and include information about the child's potential eligibility for SCHIP coverage.
* Integrating health coverage applications into foster care discharge planning sessions.
* Promoting State health coverage programs to foster care organizations.
* Engaging dependency court judges and staff in the courts.
* Expanding Medicaid coverage through age 21 for children who age out of foster care.

Children's Bureau Express Volume 4, Number 5

© 2003