Q: I understand that the Affordable Care Act will extend Medi-Cal for youth who were in foster care at age 18 to age 26. My question is: will that be EPSDT Medi-Cal (which funds the specialty foster care mental health services) or regular Medi-Cal?
A: The Affordable Care Act (ACA), passed by Congress in 2011, extended eligibility for Medi-Cal for individuals under age 26 who were in foster care at age 18 and receiving Medicaid, effective January 1, 2014. According to the ACA, youth will be eligible for this extension regardless of whether or not they were federally-eligible for foster care. Additionally, it specifies that there is no income or resource test for this group.
However, eligibility for services funded by EPSDT (Early and Periodic Screening, Diagnosis and Treatment) continue to end at age 21. At age 21, youth would no longer be eligible for the specialty mental health services provided through EPSDT. They would, however, remain eligible for these services between age 18 and 21, regardless of whether or not they are in extended foster care, as long as they are otherwise eligible for Medicaid.
A question still under consideration by the federal Administration is whether or not youth must continue to reside in the state where they were in foster care to be eligible for Medi-Cal to age 26. This requirement was included in the draft regulation. In February 2013, a coalition of stakeholders requested that this restriction be removed.
Proposed Rule: Medicaid, Children’s Health Insurance Programs, and Exchanges; Proposed Rules for Extending Medicaid to Age 26 for Eligible Former Foster Children (Fed. Reg. Vol. 78, No. 14, 1/22/13)