Conversations around Medicaid expansion often focus on adults or the economics of expansion. But there is an important group of vulnerable people in Kansas whom Medicaid expansion would help exponentially: former foster kids who have aged out of the foster care system. As a 12-year Kansas foster parent and an evangelical pastor, I believe this is a moral issue and an opportunity for the state to do the right thing for its children.
For a variety of reasons, children in our social welfare system have repeatedly been let down by Kansas. Problems with the Department for Children and Families are well documented: 70-plus children lost, lack of homes, even alleged abuse while in foster care offices. These children continue to experience trauma as they age, adding to the adverse life circumstances that first brought them into care, never through any fault of their own.
And the number of children in foster care in Kansas has continued to grow considerably — from around 4,900 in 2009 to over 7,400 in 2019. So this problem is growing rather than shrinking. Those foster children face a number of challenges if they come of age (or “age out”) while still in foster care. Some startling national statistics from the National Foster Youth Institute paint the picture:
▪ More than 23,000 children age out of the U.S. foster care system every year.
▪ After reaching the age of 18, one-fifth of foster children become instantly homeless.
▪ Only half of aged-out foster kids will be meaningfully employed by age 24.
▪ Fewer than 3% of people who age out of the foster system will end up with a college degree.
▪ One-quarter of aged-out children continue to experience post-traumatic stress disorder.
▪ And the Centers for Medicare and Medicaid Services report that up to 53% of former foster children are uninsured at 19.
The launch from living at home to surviving in “the real world” is difficult enough for anyone, but this transition to young adulthood is greatly compounded for foster children by food insecurity, PTSD and other mental health challenges, and barriers to finding housing and jobs.
Current provisions of the Affordable Care Act allow Medicaid coverage until age 26 in some instances for former foster youth (or 21 for what’s known at the “Chafee Option”). However, not all young people are covered, and many still need support well after 26.
We can improve the odds that foster kids can become productive members of society by expanding Medicaid in Kansas, keeping them on the program until they are 26. It would significantly help in their sometimes lifelong transition from state care to self-sufficiency, and would provide continuity in medical care for vulnerable young adults who often need that care because of childhood trauma.
While some have focused on the impact that Medicaid expansion would have on able-bodied adults, they often ignore the way expansion would impact former foster children. The time of ignoring them must end.
We are right to be indignant when the Kansas Department for Children and Families loses kids. We should be equally indignant when children begin adulthood without the tools they need to thrive and grow.
While discussions about government programs can quickly devolve into shouting matches, many evangelical Christians see a moral duty to care for those whom Jesus would most certainly see as the “least of these” — those who have suffered unspeakable trauma. Supporting the least of these by providing medical care not only makes the transition for aging foster children easier, but also expresses the strong belief that children are our greatest resource in this state.
Kansans pull together when times are tough — just look at the responses to recent flooding. We should also pull together to support foster children by expanding Medicaid. In spite of all the ways Kansas has failed its foster children in the past, today is an opportunity for us to unite and do something right for them.
Rich Shockey is an ordained elder in the Church of the Nazarene and executive director for a nonprofit chaplain services provider. He lives in Kansas City, Kansas.