Medicaid coverage sought for additional former foster youth

Young people from other states who have aged out of foster care would be eligible for extended Medicaid coverage in Nebraska under a bill considered by the Health and Human Services Committee Jan. 30.

LB148, introduced by Bellevue Sen. Sue Crawford, would require the state Department of Health and Human Services (DHHS) to submit a state plan amendment or waiver to the federal Centers for Medicare and Medicaid Services (CMS) on or before July 1, 2015, to provide coverage to former foster youth from other states.

Crawford said Nebraska youth who age out of foster care already are eligible for Medicaid under federal law, which mirrors a provision of the Affordable Care Act that allows young adults to remain on their parent’s insurance plan until age 26.

The bill would require DHHS to conduct outreach to all eligible young adults and to implement a federal option to accept self-attestation of foster care status and Medicaid enrollment for those individuals. The bill also would require DHHS to report annually on its outreach efforts.

Crawford said a recent interim study indicated that only 3 percent of Nebraska former foster youth are covered under the provision, and that greater efforts need to be undertaken to reach more eligible young adults.

“I think it’s very important that we use all the tools that we can,” she said.

Monika Anderson of Nebraska Families Collaborative testified in support of the bill, saying many former foster youth experience high rates of emotional and psychological disorders as well as chronic illnesses. Ensuring continuity of care is vital as state wards transition to independent living, she said.

“The outreach requirement in this bill is a vital link to this population,” Anderson said.

Former state ward Augusta Kamara agreed. Testifying in support of LB148, she said medical bills from a car accident nearly derailed her college career—bills she would not have incurred had she been enrolled in the Medicaid coverage for which she was eligible. Kamara said she now is covered under the provision for former state wards.

“This bill helps young people who are enrolled in school to focus on their educational goals,” Kamara said. “I am currently a senior at the University of Nebraska and will be the first person in my family to have a college degree.”

Amy West of the Nebraska chapter of the National Association of Social Workers also testified in support, saying the enrollment process for former state wards is flawed and needs to be streamlined.

“I worry about the number of young people who have been given false information or who have been incorrectly denied coverage,” she said.

Ruth Vineyard of the DHHS Division of Medicaid and Long-Term Care testified in opposition to the bill. She said the division already has improved the enrollment process under the federal provision and has increased the number of former state wards who are enrolled in Medicaid under the program.

Vineyard said CMS is still finalizing the rules for the former state ward population, so it is difficult to project what the ultimate cost of LB148 might be. In addition, she said, South Dakota is the only nearby state that has implemented the provision allowing former state wards from other states to enroll under their state plan.

“The potential impact from out-of-state enrollees is unknown,” Vineyard said. “If we do this, four of our five neighboring states would not be participating.”

The committee took no immediate action on the bill.