While many young adults are now covered by the Affordable Care Act, able to remain on their parents' insurance until age 26, the rules are different for those like [22-year-old Nathan] Cox-Reed, who grew up in the foster care system.
There are more than 400,000 children in foster care in the United States, the Department of Health and Human Services said last year. All are provided with health care coverage as long as they are wards of the state.
When foster kids turn 18, they age out of the system and instantly lose their coverage.
That's about to change, when another part of Obamacare takes effect on January 1, 2014. Medicaid coverage will be extended for former foster youth until they reach 26, as long as the individual was in foster care and enrolled in Medicaid until the age of 18.
"I definitely think it would be a big relief, and I would definitely feel more secure as far as my health goes," Cox-Reed said.
But there's a catch. Cox-Reed has dreams of traveling across the nation and becoming a filmmaker. A future relocation could jeopardize his medical coverage.
States will only be required to keep former foster children on Medicaid if they continue to reside in the state where they were in foster care originally.
This part of the provision is "an incredibly troubling aspect," said Washington attorney Brooke Lehmann, who founded the child and family advocacy group Childworks. Young adults can be highly mobile as they move for educational purposes, job opportunities and a host of other reasons, she said.
"You can't be on a film set if you are uninsured," Cox-Reed said. "You could get hurt. I definitely think [being uninsured] is limiting and it's a letdown, because what if I do get a job out of state? I might not be able to take it."
While "it's a great provision," said Joan Alker, co-executive director of the Georgetown Center for Children and Families and a professor at the Georgetown University Health Policy Institute, limiting extended Medicaid enrollment because of relocation could threaten the provision's effectiveness.
Image: Teenager at doctor's office, via Shutterstock