In My Eyes: Limitations of the Affordable Care Act for Foster Youth

Dustin Haley
Dustin Haley

Today’s guest blog post is written by Dustin Haley, a CCAI 2013 intern, University of Texas undergraduate student, and former foster youth.

As the Affordable Care Act (ACA) is rolled out, many former foster youth will have increased availability for medical coverage.  Starting in 2014, youth who aged out of foster care will be eligible to remain on Medicaid until age 26, a huge win for child welfare advocates and former foster youth.

Youth in college will now have the peace of mind of always having their health insurance covered, and will not have to choose between books and medical care.  Former foster youth who are working part time will also be able to support themselves without having the unnecessary burden of healthcare costs. However, limitations to the ACA will negatively impact many of the former foster youth. As a former foster youth myself, I am all too familiar with these restrictions but it wasn’t until I started interning with CCAI that I learned I could advocate to change this policy.

First Focus, a bipartisan advocacy organization, recently took a look at this regulation, in addition to the rest of the ACA as it applies to foster youth.  They found that as it stands now, coverage will only be guaranteed to those who remain in the state where they resided when they were 18.  This is a huge issue for foster youth around the nation, as they often travel to different states for extended periods for school, jobs, or internships.  Many also move to be closer to support systems, whether they are close friends or extended family.  First Focus points out that restrictions on residency only apply to foster youth, not to adopted children nor to youth raised in a traditional family.

During CCAI’s summer Foster Youth Internship (FYI) Program, foster youth from around the nation come to DC work on Capitol Hill.  Most all of them come from different states and thus are not eligible to receive Medicaid in DC.  Since I’ve started interning at CCAI, I’ve learned about one of last summer’s interns, who ended up needing medical treatment, but experienced difficulties because he was not in his “home” state.

I contacted Josh to learn more about his experience and he explained how he had just returned from a trip to Ecuador when he started as an FYI participant last summer.  Soon thereafter, Josh started to experience serious stomach issues stemming from possible parasites contracted while abroad.  He went to a quick-service clinic in DC and had to pay full cost for treatment.  Unfortunately, the practitioners in the clinics are not specialists and could not figure out what he had contracted.  Seeing a specialist in DC would have cost Josh too much money out of pocket and was thus forced to fly back to Tennessee.  He was able to get the proper treatment from a specialist there and he soon recovered.

I too have run into the same struggles as Josh since being out of my home state—Texas—and completing my internship in DC this semester.  I recently injured my knee, but due to the limitations on Medicaid, I was not able to seek out treatment.  Had I seen a doctor, they would have surely ordered X-Rays and possibly an MRI.   Without insurance, these bills quickly add up.  My struggles, along with the struggles of all foster youth, should not be lost on child welfare advocates.

The Center for Medicaid and Medicare Services recently opened up to debate the section of the Affordable Care Act regarding former foster youth.   Organizations have been able to submit comments, many of which proposed medical coverage for former foster youth irrespective of the state they resided in when they were 18.   I, for one, hope to see change that eventually leads to greater benefits to the youth.

2012 Foster Youth Interns Make their Voices Heard!

CCAI’s 2012 Foster Youth Interns (FYI) had a message to deliver to Capitol Hill: Here us now! The group of 13 former foster youth felt that for too long their voices had gone unheard, so on July 31, they released their Congressional Report and delivered an accompanying presentation to a captive audience which included Members of Congress, Hill staffers and representatives from several child welfare organizations.

For those who were unable to attend, you can watch the full briefing here.

Post-Partisan; the Power of Foster Care Politics

Note: This article originally appeared in The Chronicle of Social Change

While the nation bemoans a “gridlocked” Congress and Comedy Central’s Messrs. Stewart and Colbert aptly ridicule both Presidential candidates for a disregard of specificity on one hand and hubris on the other, I have borne witness to a very different vision of our elected leadership.

Instead of obstruction and partisanship, at least around one issue – foster care – I have seen members of Congress from both houses and sides of the aisle move at notable speed to introduce important, thoughtful legislation; respectfulness between ideologically disparate leaders; and an ability to transform the recommendations of experts in child welfare and foster youth themselves into cogent policy.

This story begins in Miami on March 31, during the second stop of the Congressional Caucus on Foster Youth’s National Listening Tour. Caucus co-founder Rep. Karen Bass (D-Calif.) sits aside Rep. Frederica Wilson (D-Fla.) and Rep. Alcee Hastings (D-Fla.) at an enormous rectangle of tables peopled with Florida’s child welfare leaders. Mary Cagle, Director of Children’s Legal Services for Florida’s Department of Children and Family Services, describes how the Family Educational Records and Privacy Act (FERPA) – intended to protect against disclosure of student records to parties other than school officials or biological parents – creates difficulties for foster children, who are no longer in the custody of their biological parents.

Amending FERPA would allow social workers access to student records, she says, helping them make critical decisions in how to best mitigate foster children’s educational challenges and celebrate their successes.

“Education is one of the biggest indicators for the happiness of our kids, so we really want the federal government to take a look at the tension in this law,” Cagle says to the assembled members of Congress.

Two short months later, on the last day of May, National Foster Care Awareness Month, Rep. Bass and Foster Youth Caucus Co-Founders Michele Bachmann (R-Minn.), Rep. Jim McDermott (D-Wash.) and Rep. Tom Marino (R-Penn.) introduced a bill that would eliminate that tension by allowing child welfare agencies direct access to the records of students in foster care, and allow for aggregate data to be used in studies intended on improving educational outcomes for students in foster care.

“This was an issue waiting to be resolved,” Rep. Bass said in an interview on the eve of the bill’s introduction, which would eventually take the name of the Uninterrupted Scholars Act. “The thought had already been put in, all we did was take advantage of the thinking and the work that was in place.”

Through the summer, foster care advocates and hill staff worked behind the scenes to elevate the issue and make sure it carried momentum through an increasingly static legislative season. As is so often the case with child welfare issues, it was a combination of expert analysis and foster youth perspective that moved the Uninterrupted Scholars Act into the Senate, increasing the likelihood it will become law before the end of this Congress.

On July 20, R.J. Sloke sat down with Sen. Roy Blunt (R-Mo.) to tell the lawmaker his story of growing up in foster care. It was the last day of Sloke’s internship through theCongressional Coalition on Adoption Institute’s Foster Youth Internship (FYI) Program, which places foster youth in the offices of Members of Congress.

The 2012 Foster Youth Interns immediately following their briefing on July 31, 2012.

“It felt really good,” Sloke said after a briefing in the Senate Visitor’s Center where he and 12 other of this year’s Foster Youth Interns released a report entitled “Hear Me Now” filled with their policy recommendations. “I told him about my high school situation and how the bill [Uninterrupted Scholars] would have helped me.”

According to the report he contributed to “Hear Me Now,” Sloke lived in 25 foster care placements in the five years he was care before his 18th birthday. All the bouncing through foster homes and group homes resulted in his attending a dozen different high schools.

“My caseworkers and schools failed to communicate with each other as I would transfer schools resulting in my not receiving credits to go on to the next grade,” he wrote in the report. Despite taking ninth grade three times, Sloke managed to graduate at 19.

Sloke’s story touched Blunt, who signed on as a co-sponsor of the Uninterrupted Scholars Act. On August 2nd, Sens. Mary Landrieu (D-La.), Chuck Grassley (R-Iowa), Mark Begich (D-Ala.), Barbara Boxer (D-Calif.), Al Franken (D-Minn.), Amy Klobuchar (D-Minn.) introduced the law into the Senate.

In an interview just minutes before the bill was run to the Senate floor, Sen. Landrieu, Co-Founder of the Senate Caucus on Foster Youth, described just how important hearing from youth like Sloke is to legislators.

“This kid, even after having to go through ninth grade three times, not because he couldn’t do the work but because the system had lost his records, now he’s gone on to graduate…. He will be a phenomenal leader in our nation but you know this is just way beyond what should be required. That is R.J.’s situation and there are thousands of other cases like it.”

Much like the House bill, Uninterrupted Scholars will: give child welfare agencies access to foster student records; allow for the use of educational records in studies related to promoting the educational success and stability of foster youth; and eliminate the need for duplicative, time-consuming notice when transferring records.

2012 Foster Youth Intern R.J. Sloke with Rep. Karen Bass (D-Calif.). Sloke played a key role in a collective effort to maintain momentum behind the Uninterrupted Scholar’s Act.

On August 3rd, the day before Congress took its summer recess, I had a chance to sit with Congressional Caucus on Foster Youth co-chair Michele Bachmann. After explaining her experience as a foster mother to 23 foster children and five “biologicals,” Bachmann took a moment to explain the significance of having caucuses on Foster Youth in both houses.

“A lot of people think we can never talk about anything in Congress, that everything is gridlock and everything is partisan, and it isn’t at all. So both Congresswoman Bass and myself have come together. We created the Foster Youth Caucus, a bi-partisan caucus to elevate the issue of the problems and challenges that families deal with, with foster care, because we want solutions. That’s what we are about. Positive solutions to actually help the life situations for families in challenging situations.”

Representative Bachmann discusses the importance of the Uninterrupted Scholars Act. 

While Bachmann — like Landrieu had the day before — repeatedly referenced the goal of finding “forever families,” she noted the importance of Uninterrupted Scholars.

“We filed our bill in the House, now we see the Senate’s followed suit. We do have time yet in the remainder of this year to advance the cause of children in challenging circumstances that is what we are here to be about…. Our goal is to place children in forever families, but along the way, along the path of that journey we want them to have the best possible educational [opportunities], because if there is anything I learned personally as a foster mother its that our foster children needed a leg up.”

Congress will reconvene in early September, just as hundreds of thousands of American students start a new school year. If momentum carries Uninterrupted Scholars through, students in foster care may have that much needed leg up on the road to educational success.

Daniel Heimpel is the Executive Director of Fostering Media Connections and the Publisher of the Chronicle of Social Change. 

CCAI Foster Youth Interns Tell Capitol Hill: Hear Us Now!


CCAI’s Foster Youth Interns (FYI) have released a report, “Hear Me Now.” In it, the former foster youth share their personal experiences as well as policy recommendations to address child welfare issues, including:

  • Use of psychotropic medication among foster youth,
  • Indian Child Welfare Act (ICWA),
  • Post-secondary education financing,
  • Juvenile justice system crossover, and
  • Human trafficking, in addition to various other foster care-related topics.

In past years, these reports have generated both local and national attention to the critical issues facing the 408,000 children currently in the United States foster care system.

“It has been my experience that the voices of foster care alumni are the ones we should be listening to more than any others. When they speak, things actually stand a chance of getting better. Not because their stories remind us of how far we have yet to go, but because their ingenuity and passion for making a difference show us just how far we can reach,” said Kathleen Strottman, Executive Director of CCAI. “Each and every day, the FYIs use their voice on behalf of those who do not have one. They reveal their scars in the hope that others won’t have these same wounds inflicted upon them.”

Since its inception in 2003, over 100 former foster youth from across the country have produced four legislative reports and have hosted nine Congressional briefings. Over 100 specific policy recommendations have been presented to federal policymakers, and at least three have been enacted into law.

Please click here to read the report:


CCAI Survey Seeks to Learn More about Family Care and Foster Care

CCAI is conducting a survey to learn more about the experiences of individuals who grow up in foster care and people who grow up in family care. Please take 3 minutes to complete the survey; the results will be used in a report that the Foster Youth Interns will present at a Congressional Briefing on July 31!


More than an internship

Interning with CCAI means more to me than just a way to expand my skill set and enhance my resume. As a member of an adoptive family, this internship is yet another opportunity to be a part of the cause of finding families for every child. I’ve been a part of the adoption cause since I was four years old when I first overheard my parents discussing the prospect of bringing a sibling into the family—a moment I still vividly remember. Before I knew it, Thanksgiving Day 1996 had arrived, and I was waiting at the airport for what seemed like hours to finally see my brand new sister come off the airplane and into our lives.

Other adopted kids, adoption agencies, National Adoption Day…I’ve been exposed to it all for fourteen years now. Our summers were filled with picnics and pool parties with other adopted children from Russia, Vietnam, South Korea, and dozens of other countries. The highlight of my experience with adoption came last summer when I travelled with my sister and mom to my sister’s orphanage in Rostov-on-Don. I was familiar with the look of the building after years of watching the home videos my dad had taken, but nothing quite prepared me for the dozens and dozens of little children who were all so excited to see the visitors from America. I was moved to meet “mamas” and nurses who could still remember my sister from more than a decade before. The most overwhelming emotion for me was that, for once, I felt as though I had been adopted. I was greeted with as much enthusiasm as my sister by our hosts even though I am not an adopted child and had never met them before.

Last week at the events for Angels in Adoption, I was faced with the same heartwarming feeling of the adoption community. Angels that I had communicated with over the phone and by email were even more gracious in person, and their excitement was infectious. I was repeatedly impressed with their efforts to find permanent homes and families for children the world over, and I constantly wished that I had more time to talk with them about their personal stories. It was so fulfilling to finally meet someone who had formerly been just a biography or a slideshow photo. Every smile and hug made my hours at the office seem like nothing.

In particular, I came away with an even greater appreciation of what my parents did for our family in adopting my sister. I feel so grateful to not only CCAI but the Angels for giving me the opportunity to make a contribution back to the adoption community. I’ve learned so much already, and I can’t wait to see what this internship has in store for me for my next two months.

-Charlotte McCoy, 2010 Fall Intern

Charlotte: bottom row, 2nd from right