• December 2015
  • Vol. 16, No. 9

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Comparing Federal Laws Providing Medicaid Coverage

Both the Fostering Connections to Success and Increasing Adoptions Act of 2008 (Fostering Connections, P.L. 110-351) and the Patient Protection and Affordable Care Act of 2010 (the ACA, P.L. 111-148) extend Medicaid coverage to eligible youth beyond age 18. In a recent Practice Bulletin, the Association of Administrators of the Interstate Compact on Adoption and Medical Assistance (AAICAMA) compares the provisions of the two laws as they relate to Medicaid eligibility.

The Fostering Connections Act is a child welfare law that:

  • Gives States the option to extend title IV-E eligibility for youth to remain in foster care to ages 19, 20, or 21 as long as they meet certain educational or work requirements
  • Allows States to provide title IV-E adoption/guardianship assistance to youth adopted or placed with a guardian at age 16 or older
  • Expands Medicaid coverage to all youth in foster, adoption, and guardianship placements as Medicaid is mandatory for all title IV-E recipients in all States

The ACA is a medical assistance law that:

  • Requires States to provide Medicaid coverage to age 26 to youth who aged out of State or Federal foster care while Medicaid eligible and who continue to live in the foster care State
  • Gives States the option to extend Medicaid eligibility to age 26 to youth who were in foster care in another State
  • Applies to only title IV-E and State-funded former foster youth

An explanation of the Fostering Connections' work and education requirements is provided in the bulletin. The publication also includes a quick-reference, side-by-side comparison chart of the major provisions of the two laws, as well as citations of the laws and policies on which the comparisons are based.

AAICAMA's Practice Bulletin, 2(4), December 2014, is available at http://aaicama.org/cms/Practice_Questions/PracBulletin_Compare_FC_ACA.pdf (157 KB).

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