SAN FRANCISCO – Angela Stark waited in line for nearly two hours at the San Francisco Department of Human Services office to hand over her Medi-Cal application. She then waited another hour before an enrollment worker interviewed her to see if she was eligible.
Just three weeks shy of her 22nd birthday, Stark had been uninsured since aging out of foster care at age 18.
Each year, over 20,000 young people age out of the foster care system in the United States. In California alone, between 2,700 and 5,000 youth age out.
Stark didn’t know enough about Obamacare to ask the enrollment worker whether she qualified for a provision that extends Medi-Cal coverage to former foster youths until they turn 26, regardless of their immigration status, where they live or how much they earn. Medi-Cal, the state-run insurance plan for the poor, is known as Medicaid in the rest of the nation.
All that the law requires is that they must have been in foster care when they turned 18 and have previously received Medi-Cal as wards of the state. Former foster care youth are entitled to coverage even if they live in states that aren’t expanding their Medicaid programs.
Last week, Children Now, a California-based youth advocacy organization, launched the Coveredtil26 statewide outreach campaign to ensure that former foster youth living in the state know they are eligible for Medi-Cal coverage until they turn 26. A number of other children’s advocacy groups are participating in the campaign.
One of the advantages of getting Medi-Cal through the foster care program is that income doesn’t disqualify the youth, unlike in regular Medi-Cal where the individual can make no more than 138 percent of the federal poverty law – in California, that’s just a little under $16,000 a year.
Another advantage is that the former foster youth will have “uninterrupted eligibility” until age 26, without the person having to fill out an annual redetermination form, pointed out Barbara Facher, a social worker with Alliance for Children’s Rights.
The measure is designed to give the former foster children similar opportunities to other young adults, who can stay on their parents’ insurance until they turn 26. It’s not unusual for former foster youth to be unaware that they are eligible for the free coverage, which includes preventive care and vision and mental health services. In May, Medi-Cal will also offer them free dental care.
There isn’t a universal database of foster children, and social service providers may not find them in county computer records. Former foster care youth seeking to enroll may not have evidence of their time in the child welfare system.
An even greater obstacle, according to advocates, is that a state is not required to provide Medicaid coverage to young adults who aged out of foster care in another state. So youths who have moved across state lines since their time in foster care may not qualify. California, however, has decided “to honor kids who come out of other states,” notes Facher.
High risk population
Without family or any other dependable adults to rely on for assistance, former foster youth are at high risk of homelessness, illness, incarceration, welfare dependency, early childbearing and physical victimization, say children’s rights advocates.
Getting the word out can be difficult, notes Margo Levi, who oversees counseling and therapy at Huckleberry Youth Program in San Francisco. Former foster kids often disappear from the system and end up on the streets.
“They have tenuous living situations,” Levi says.
Most children are covered under Medi-Cal while in foster care, and in some states, including California, that coverage has more recently been extended until their 21st birthday. Afterward, they often become uninsured.
“”They need all the support services they can get to transition to adulthood successfully,” observes Jessica Haspel, a child welfare policy associate with Children Now.
“Simply putting a child in foster care is an adverse event” in itself that can lead to mental illness, notes Rusty Selix, executive director of advocacy group, California Council of Community Mental Health Agencies (CCCMHA). He said 90 percent of children in foster care have a mental illness from what researchers call “adverse childhood experiences.”
Lavette Williams was living with a drug-addicted mother at the time her 17-year-old brother was killed on Divisadero Street in 2006 in a hail of gunfire. Williams, then 13, became withdrawn and depressed. Her aunt took her into her home as a foster child, but her depression deepened.
A social worker took her to a therapist who diagnosed her as emotionally disturbed. A psychiatrist prescribed Riasperdal, an anti-psychotic drug. Williams says she stopped taking it after three months because it was making her fat. She turned to marijuana “so I can get out of reality,” she says.
Now, 23, and the single mother of a 15-month-old daughter, Williams is having a hard time making ends meet with her $800 monthly SSI and the $300 she makes each month from her part time job for a security firm. She feels that getting out of her depression is key to finding herself a full time job, which is why she applied for Medi-Cal recently.
“(Former foster youth) are desperate to have health insurance because they could find themselves with hospital bills they cannot pay, and it ends up on their credit report,” Facher says.
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