S2837-118

What This Bill Does

The Expanded Coverage for Former Foster Youth Act (S. 2837) amends the Social Security Act to ensure that young adults who were in foster care can maintain Medicaid health insurance coverage until age 26. The bill addresses a gap in the current system where former foster youth may lose their health coverage when they age out of foster care at 18 (or up to 21 in some states).

The legislation does two main things:
1. Expands Medicaid eligibility to include former foster youth up to age 26, even if they left foster care through a kinship guardianship arrangement or were emancipated before turning 18
2. Requires states to establish outreach programs by January 1, 2024, to actively find and enroll eligible former foster youth in Medicaid coverage

Who Benefits and How

Former Foster Youth (Primary Beneficiaries)
- Young adults who aged out of foster care at 18 (or later in states with extended foster care) gain guaranteed access to Medicaid coverage until age 26
- Youth who left foster care to live with kinship caregivers (such as grandparents or other relatives) are now explicitly included, closing a previous loophole
- Youth who were emancipated from foster care before turning 18 also become eligible
- This provides critical health coverage during a vulnerable transition period when many young adults lack employer-provided insurance

Healthcare Providers
- Hospitals and clinics serving this population will have more patients with insurance coverage, reducing uncompensated care costs

Who Bears the Burden and How

State Governments
- Must fund expanded Medicaid coverage for a larger pool of former foster youth, though federal matching funds help offset costs
- Must design, staff, and administer new outreach and enrollment programs by January 2024
- Must coordinate across multiple state agencies (child welfare, Medicaid) to identify and enroll eligible individuals

Federal Government (via HHS)
- The Secretary of Health and Human Services must establish "best practices" to guide state outreach efforts
- Federal Medicaid spending will increase due to expanded eligibility

Key Provisions

1. Section 2 - Expanded Eligibility: Rewrites the Medicaid eligibility criteria to include three groups of former foster youth under age 26:
2. Those who aged out of foster care at 18 or the state's extended age
3. Those who left foster care for kinship guardianship at any age

4. Those emancipated from foster care before age 18

5. Section 3 - Mandatory Outreach: Requires every state to establish an enrollment outreach program by January 1, 2024, working with child welfare agencies and other partners to ensure eligible youth know about and enroll in their Medicaid benefits

6. Effective Date: Changes take effect January 1, 2024, applying to individuals who turn 18 on or after that date