Bill would ease health coverage access for former foster kids

BOSTON — Most Bay State residents don’t have to do anything to keep their health insurance coverage when they turn 18 because they’re able to stay on their parents’ insurance plans. But for teens who age out of the foster care system at 18, the process can be a lot more complicated.

While the federal Affordable Care Act allows teens and young adults to stay on their parents’ insurance until they turn 26, it also requires that states provide Medicaid coverage to foster care children when they age out of the system. But unlike their peers who stay on their parents’ insurance, former foster kids are required to re-enroll every year, a process that advocates say is cumbersome and leads to a gap in coverage.

“Currently, (the Department of Children and Families) ensures that all youth aging out of care are enrolled in MassHealth. However, there are access barriers in the current system. The first year after enrollment, youth need to re-apply. So for all of us who have our own health insurance, we know how cumbersome that is. Now imagine for a young person who often, post-18 who has aged out of care, doesn’t know where they’re sleeping or are transient,” Tammy Mello, the executive director of the Children’s League of Massachusetts, said. “And because of the transient nature of former foster youth, many of them don’t even receive notice that they need to re-apply.”

Mello urged passage of legislation (H 124/S 35) that would codify DCF’s current practice of automatically enrolling 18-year-olds into MassHealth and establish a provision that would allow former foster kids to be automatically re-enrolled in MassHealth each year. She said the Committee on Children, Families and Persons with Disabilities gave the bill a favorable report last session and asked that committee members do the same this go-round.

The committee also heard Tuesday from Boston Children’s Hospital Director of State Government Relations Kate Audette, who told lawmakers about her experience as a foster parent who oversees medical care. She told the committee that a young girl currently placed in her home has a chronic diagnosis and had an appointment with her doctor scheduled for Tuesday morning while the committee hearing was taking place.

“I skipped this child’s doctor appointment this morning because I know that right now she has access to the care that she needs ... but what I’m worried about is what happens when she turns 18 because if her coverage were to lapse, in the amount of time it would take to get a redetermination completed she would be hospitalized,” Audette said. “What I am terrified about is what happens when she transitions out of the system.”

Child Advocate Maria Mossaides, a gubernatorial appointee charged with overseeing the health and safety of children involved with the state, also testified in favor of the legislation, arguing that the state has a parental duty to ensure that the kids in its care will have health insurance.

“Young adults in this commonwealth are covered by their parents’ health insurance and they do not need to re-apply every year, instead they are automatically covered as long as their parents complete the required paperwork. This should be the same for children in the foster care system,” Mossaides said. “These youth who age out of care are the commonwealth’s children. The commonwealth was given custody by the courts and just like other parents we need to continue to take seriously our obligation to ensure that at the very least they’re covered by health insurance.”