Maintaining Health Benefits for Children Transitioning from Foster Care

Extension of Medicaid health benefits to age 21 is critical for young people transitioning from foster care into adulthood to help prevent negative outcomes and to promote their well-being and successful adjustment.

Young People Leaving Foster Care at Age 18 Need Health Insurance but Often Do Not Have It

These young people face significant hurdles in obtaining health care coverage. A recent study of these youth in a large midwestern state found that:

  • 51% had no insurance coverage.

  • 44% rated "obtaining medical care" as a problem most or all of the time. This was reported as a bigger problem than finding employment or having money.

  • Although these young people had less access to care, they reported significantly higher levels of physical and mental health problems.

These Youth are at Greater Risk for Negative Health and Behavioral Outcomes

The vast majority of young people in the foster care system are there because they have experienced some form of childhood maltreatment. Research tells us that negative childhood experiences, especially abuse and neglect, can adversely affect adult health and mental health.

  • Health Consequences. Adults with a history of aversive childhood experiences are more likely to experience heart disease, cancer, lung disease, and skeletal fractures. They are also more likely to be obese, have diabetes, and engage in behaviors associated with poor health outcomes.

  • Mental Health and Substance Abuse. The negative outcomes are not only medical. Adults with aversive childhood experiences are also more likely to be depressed, attempt suicide, have unintended pregnancies, and have personality disorders. Substance abuse problems and alcoholism are also correlated with negative childhood experiences.

  • Criminal Behavior. Child abuse and neglect increase the odds of delinquency and adult criminality by 40 percent. Abused children are more likely to be arrested later in life than their non-abused peers, and commit more serious offenses.

Extension of Medicaid Benefits Will Help Address the Needs of These Youths

  • Many of the negative outcomes mentioned above, even serious conditions such as heart disease, lung disease, and suicidal depression, are often preventable. Health care benefits will allow young people to receive treatment for health or mental health problems before the problems become severe.

  • Medicaid benefits will allow these young people to focus on normal tasks for 18-to-21 year olds-- seeking employment, attending school, or establishing themselves in the community-- rather than on paying for health insurance.

  • Many young Americans receive health insurance and other forms of assistance from their families even after they turn 18. Medicaid benefits will provide young people aging out of foster care with at least some of what their same-age peers receive.  


Courtney, M.E., Piliavin, I., Grogan-Kaylor, A., & Nesmith, A. (1998). Foster youth transitions to adulthood: Outcomes 12 to 18 months after leaving out-of-home care. School of Social Work, University of Wisconsin-Madison.

Felitti, V.J., Anda, R.J., et. al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14 (4), p. 245-253.

Widom, C.S. (1992). The cycle of violence. National Institute of Justice.