Health care

Spoiler Alert: Medicaid is Confusing!


Hi, everyone! My name is Sara Matthews. I am a rising fourth-year at the University of Chicago majoring in Public Policy with a focus in health policy and human rights. Thanks to funding from UChicago’s Pozen Center for Human Rights, I have spent the last 10 weeks interning with FosterClub, working primarily on the #HealthCareFFY campaign. The #HealthCareFFY campaign focuses on the Affordable Care Act and its former foster youth (FFY) provision, which makes FFY eligible for Medicaid until they are 26 years old.

When I arrived at FosterClub, I was incredibly excited. Health issues have always been especially meaningful to me. I grew up with two chronically ill parents, so I understand just how important access to health insurance and health care can be. Throughout the summer, I have facilitated webinars, written blogs and issue papers, and helped update the #HealthCareFFY website. However, hands down, my most frustrating and time consuming project has been the 50 State Survey. The purpose of the 50 State Survey is to collect information about how the FFY provision of the ACA is being implemented and how youth can apply for coverage in each state.

At the start of my internship, I was pretty confident in my ability to complete the survey with relative ease. Health care is my specialty, and I knew I had access to all of FosterClub’s resources to support me in the process. I soon learned just how wrong I was.

Medicaid is confusing and finding the information was hard. Most states do not have resources explaining the specific application and renewal processes for FFY, and very few states had easy-to-find contact information for people that could answer my questions. Even among states that had contact information listed, it took persistence on my part to receive a response with the necessary information. Over the course of the past 10 weeks, I have sent countless follow-up emails (and follow-up follow-up emails). Often times, even the Medicaid and Child Welfare officials that I was in contact with were unfamiliar with the process and had to spend weeks tracking down the information themselves. This is not to find fault with the officials I spoke with. They are incredibly busy people, overseeing a wide array of programs, and FFY represent a small portion of the overall US population. Nevertheless, I could not help but wonder...if these government officials did not know the information, how were youth supposed to figure it out?

The bottom line? In completing the 50 State Survey, I had everything going for me. I am incredibly privileged. I have access to a wide variety of academic and professional resources to help me. I have dedicated my academic career to studying policy and health care. Last year, I even spent an entire quarter researching the Affordable Care Act and how it applied to FFY. Here at FosterClub, I have access to our entire professional network of contacts and was able to reach out to my managers for guidance. To top it all off, this was one of my sole responsibilities for the last 10 weeks. Figuring out these processes was literally my job.

Despite all of this, making progress with the survey was incredibly difficult. There were moments when I wanted to pull my hair out in frustration! If I struggled so much, I can only imagine how difficult navigating health care must be for youth who do not have access to these same resources and who also have to balance school, work, and the rest of their lives.

According to the ACA, health care is not a privilege. It is something to which all FFY under the age of 26 are entitled. However, this theoretical ideal is far from reality for many FFY who struggle to figure out (or are unaware of) their state’s Medicaid application process. FosterClub is already in the process of creating a centralized resource hub to help alleviate the informational burden on FFY. States should follow suit, creating specific websites dedicated to Medicaid for FFY and keeping them up-to-date with clear application and contact information.

I have had an incredible time working with FosterClub this summer. The lessons that I have learned from the staff and the All-Stars will stay with me and continue to inform my own advocacy efforts for years to come. However, my experiences this summer also highlight a critical gap in current health policy. They make it clear that providing FFY with nominal Medicaid eligibility is not enough. We as a society must do better to ensure that youth are actually able to apply for and access the health care services they so desperately need.

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