In 2014, the Affordable Care Act will require all Americans, including young people aging out of the existing Medicaid program, to have health insurance (or pay a penalty). The physical, behavioral, and developmental health problems of the young people leaving Medicaid have rarely been studied. The purpose of this paper is to provide a snapshot of their health status and cost in selected states, focusing particularly on two high-cost groups that are automatically entitled to Medicaid—youth in foster care and youth receiving Supplemental Security Income (SSI). In addition, we focus on those with behavioral and developmental health problems, regardless of their basis of eligibility.
Over 15 percent of American youth have a diagnosable behavioral health problem, including mental health or substance abuse disorder problem, and a similar percentage have a developmental disorder (Boyle 2011), with substantial overlap in the groups. In addition, most life-long behavioral and developmental health problems are evident by adolescence (Institute of Medicine 2009).