Performance Improvement 2013-2014. What Insights Can be Drawn from States Experiences Implementing Optional Medicaid Coverage for Youth in Order to Help With Mandatory Coverage?


This study drew lessons from 30 states' implementation of existing optional Medicaid coverage for youth who age out of foster care and applied them to decisions and plans states will consider as they implement new Affordable Care Act coverage that goes into effect in 2014. Under the Affordable Care Act youth who age out of foster care remain categorically eligible for Medicaid until age 26.

The study found that wide variations in how states have implemented the so-called Chafee Option are focused on eligibility criteria, enrollment processes, and recertification processes. States' implementation choices had implications for the frequency with which youth enroll in Medicaid coverage after foster care and in their continuity of coverage over time. While youth remained eligible for Medicaid, states with more burdensome enrollment and recertification processes had lower rates of continuing coverage than states with more streamlined processes. States have approached and devised solutions to a series of implementation challenges such as coordinating data systems and forms, training staff about the new coverage, and helping youth maintain coverage. One of the biggest challenges states will face in implementing the provision for youth formerly in foster care is keeping them aware of their continued categorical Medicaid eligibility. That includes keeping youth aware, but also keeping service providers from other systems (e.g., mental health and substance abuse providers, TANF providers, criminal justice providers) aware of the provision.

Report Title: Assessing Medicaid and Housing Supports for Youth Who Age out of Foster Care
Agency Sponsor: OASPE, Office of the Assistant Secretary for Planning and Evaluation
Federal Contact: Laura Radel, 202-690-5938
Performer: Urban Institute
Record ID: 9533 (November 16, 2012)

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"PerformanceImprovement2014.pdf" (pdf, 671.65Kb)

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