Obamacare, Fostering Connections Carry Potential to Lower Foster Teen Pregnancies

By Jeremy Loudenback

For the many current and former foster youth without good access to family planning information, enrolling in the new health care plan may be the best medicine.

The partisan bickering continues over the rollout and overall merits of the Patient Protection and Affordable Care Act  (ACA). But there is hope that the new health care law may help stem the high rate of teen pregnancies among foster youth, who are more than twice as likely as their peers to get pregnant.

As of January 1 of this year, all former foster-care youth are able to qualify for Medicaid under the ACA, and coverage for former foster youth extends to age 26. This provision has offered an important measure of parity for a vulnerable population that doesn’t have the same opportunities provided to children with a parent, according to Jennifer Friedman, an attorney at the National Center for Youth Law who has worked on issues of reproductive health care for foster youth.

“I think the availability of care and coverage is incredibly important to this population,” Friedman said, “but there are a lot of questions and challenges to be figured out.”

In California, advocacy group Children Now hopes to assist in reaching out to current and former foster youths about the new law. The organization recently launched the website Coveredtil26.com, part of a campaign to promote awareness and increase enrollment of former foster youth in Medi-Cal under the ACA. The site includes frequently asked questions, resources, and enrollment tips with the goal of reducing enrollment barriers for former foster youth.

Research indicates that the best prospects for connecting foster youths with health care will be in states that expand their foster care system to age 21, a prospect made easier for states after the passage of the Fostering Connections to Success and Increasing Adoptions Act in 2008. The law permits states for the first time to seek federal reimbursement for foster youths between the ages of 18 and 21.

In an article published last year in the Journal of Health Politics, Policy and Law, researchers from the University of Chicago and the Seattle Children’s Research Institute observed that foster youth who were able to stay in foster care until their 21st birthday were more likely to have access to health care.

Researcher Amy Dworsky of Chapin Hall at the University of Chicago and her team examined 378 girls in foster care in Illinois, Iowa, and Wisconsin as part of the Midwest Evaluation of the Adult Functioning of Former Foster Youth, a longitudinal study that has been tracking a sample of young people as they have moved out of foster care and into independence.

As young women age out of the foster care system, they are still at a high risk of becoming pregnant, according to Dworsky.

“Our results suggest that by allowing young people to remain in foster care until they are 21, they are more likely to be able to obtain healthcare and access to family planning resources,” Dworsky said. California, like Illinois, allows foster care youth to stay in the system until age 21.

Access to health care coverage, particularly in the case of reproductive health, may be limited because many foster children aren’t aware health programs are available to them and don’t know how to find the information.

Foster youth have traditionally faced many barriers to receiving family-planning information. Some children have been placed with families that have been reluctant or unwilling to talk about sex, while others have had to change school often while being bounced from placement to placement, decreasing the likelihood of receiving coherent family-planning education at school.

Not coincidentally, the pregnancy rate among foster teens has remained high as rates for girls across the country have steadily declined for two decades. According to a survey conducted by the Chapin Hall Center for Children between 2002 and 2004, teenage girls in foster care are two and a half times more likely than their peers to become pregnant, an alarming statistic that provides a stark contrast to diminishing rates of teen pregnancies in recent decades.

Research has shown that teens in foster care are also more likely to engage in sexual activity and have higher birth rates (both wanted and unwanted) than youth of similar ages. They are also more likely to drop out of school, deal with substance abuse, and be incarcerated during adolescence.

Then there are the intergenerational effects: children of teen mothers face higher odds of ending up in foster care themselves.

Jeremy Loudenback is a student at USC’s Sol Price School of Public Policy. He wrote this story as part of the Media for Social Change class. 

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