Access to health care for youth leaving foster care: Medicaid and SCRIP

Purpose: To examine how Medicaid and the State Children's Health Insurance Program (SCRIP) could improve health care access for youth aging out of foster care, a vulnerable population with multiple health concerns. Methods: On the basis of an analysis of state and federal laws, state plans and amendments, and a telephone survey of state officials, this article identifies options in Medicaid and SCRIP for states to provide health insurance coverage for these youth, examines states' use of available options, and highlights other relevant federal health care programs. Results: Numerous Medicaid and SCRIP eligibility categories could provide coverage for older adolescents leaving foster care. The federal Foster Care Independence Act of 1999 (FCIA) created a new Medicaid expansion option for this group and other opportunities for states to address their health care needs. Numerous other federal programs also finance health care that could serve this population. Conclusions: The potential exists through Medicaid or SCRIP to ensure that nearly all former foster youth have health insurance as they leave state custody, but Medicaid and SCRIP cannot alone meet all health care needs of these youth. Financing available through other public programs is essential. A few states have adopted the new FCIA Medicaid expansion option for former foster youth, and a larger number have implemented other relevant Medicaid options. Additional states have used other innovative approaches to facilitate health care access. Most states could do much more. A major challenge is to find approaches that can be implemented during times of severe budgetary limitations. (C) Society for Adolescent Medicine, 2003.