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For Former Foster Kids, Moving Out of State Can Mean Losing Medicaid

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By Anna Gorman , Kaiser Health News

 

Soon after moving to Utah this summer, Rainbow Sky Buck ended up at the hospital with a painful ear

infection. There, Buck learned she no longer had access to the free health coverage she had in California as

 

a former foster youth.

 

To pay for the care, Buck emptied out her bank account and borrowed money. “Luckily, I got my

antibiotics and I am okay now,” she said. “But what is going to happen next time?”

 

Under the health law, young adults who age of out of the foster care system are eligible for free Medicaid

coverage until they turn 26. The provision was an attempt to give them the same opportunity as other young people who can stay on their parents’ insurance until their 26th birthday.

 

But these young adults are encountering a major barrier: They are only guaranteed coverage in the state

where they were in foster care. States have the option of extending the benefit to all former foster youths,

but only about a dozen have done so.

 

Now, advocates and policymakers are trying to change the law at the federal level, so former foster youths

don’t lose access to Medicaid coverage no matter where they move.

 

Reps. Karen Bass, D-Calif., and Jim McDermott, D-Wash., have proposed legislation that would allow

them to qualify for Medicaid, the government health program for low-income Americans, in any state.

 

Sen. Bob Casey, D-Pa., has introduced a similar bill that he said would be a simple clarification of what

Congress intended. Meanwhile, advocates are pushing the Centers for Medicare & Medicaid Services to

change its interpretation of the original provision.

 

First Focus, which advocates for foster youths, has been receiving calls from young people who had no idea

that they would lose health insurance when they moved.

 

“We really do feel an urgency about this,” said Shadi Houshyar, vice president of child welfare policy at

the organization. “So many people who have aged out have significant health needs and coverage is so

important. There shouldn’t be an additional barrier.”

 

Former foster youths are more likely than their peers to have physical and mental health needs, experts say.

 

Ongoing research in Illinois, Wisconsin and Iowa shows that 22 percent of former foster youths had been

hospitalized at least once in the previous year and one-third had two or more emergency room visits.

 

Just like other young people, former foster youths move to different states for school, jobs or family, said

Fatima Morales, policy and outreach associate for the advocacy group Children Now. Morales said they

shouldn’t be penalized for doing so.

 

Morales said her organization is trying to inform youths what they might face if they move. “They need to

know how their health coverage might be impacted,” she said. “It’s just something that they need to weigh.”

 

Lezlie Martinez, 19, is weighing her options now. She is hoping to move from California to Colorado

because she wants to live in a place with a lower cost of living. Her boyfriend is already there and she is

looking for hospitality jobs to support herself and her 2-year-old son.

 

But she worries that she may be left uninsured and unable to pay for medical treatment for eczema,

allergies and fibromyalgia. “It is causing foster youth to be stuck in the same state they were raised in,” said

Martinez, who lives in Oceanside, Calif. “It is really stressing me out.”

 

Buck said she decided to move to Sandy City, Utah, because of the limited job prospects in the small

northern California town of Crescent City. Before moving, she asked social workers about whether she

would still qualify for free health coverage and was told that she would. Buck said she was shocked to learn

otherwise.

 

She is no longer seeing a therapist for depression and said she is weaning herself off antidepressants

because she can’t afford them. Buck said she also worries about getting another ear infection and not being

able to afford treatment.

 

“It is just scary to think I am completely on my own,” said Buck, who recently got a job at an automotive

shop but doesn’t get insurance from her employer. “I don’t want to leave, but this is almost forcing me to

move back to California.”

 

Kaiser Health News can be reached at http://khn.org/

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Activism

COMMENTARY: The Biases We Don’t See — Preventing AI-Driven Inequality in Health Care

For decades, medicine promoted false assumptions about Black bodies. Black patients were told they had lower lung capacity, and medical devices adjusted their results accordingly. That practice was not broadly reversed until 2021. Up until 2022, a common medical formula used to measure how well a person’s kidneys were working automatically gave Black patients a higher score simply because they were Black. On paper, this made their kidneys appear healthier than they truly were. As a result, kidney disease was sometimes detected later in Black patients, delaying critical treatment and referrals.

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Sen. Akilah Weber Pierson, M.D (D-San Diego). File photo. Sen. Akilah Weber Pierson, M.D (D-San Diego). File photo.
Sen. Akilah Weber Pierson, M.D (D-San Diego). File photo.

By Sen. Akilah Weber Pierson, M.D., Special to California Black Media Partners 

Technology is sold to us as neutral, objective, and free of human flaws. We are told that computers remove emotion, bias, and error from decision-making. But for many Black families, lived experience tells a different story. When technology is trained on biased systems, it reflects those same biases and silently carries them forward.

We have seen this happen across multiple industries. Facial recognition software has misidentified Black faces at far higher rates than White faces, leading to wrongful police encounters and arrests. Automated hiring systems have filtered out applicants with traditionally Black names because past hiring data reflected discriminatory patterns. Financial algorithms have denied loans or offered worse terms to Black borrowers based on zip codes and historical inequities, rather than individual creditworthiness. These systems did not become biased on their own. They were trained on biased data.

Healthcare is not immune.

For decades, medicine promoted false assumptions about Black bodies. Black patients were told they had lower lung capacity, and medical devices adjusted their results accordingly. That practice was not broadly reversed until 2021. Up until 2022, a common medical formula used to measure how well a person’s kidneys were working automatically gave Black patients a higher score simply because they were Black. On paper, this made their kidneys appear healthier than they truly were. As a result, kidney disease was sometimes detected later in Black patients, delaying critical treatment and referrals.

These biases were not limited to software or medical devices. Dangerous myths persisted that Black people feel less pain, contributing to undertreatment and delayed care. These beliefs were embedded in modern training and practice, not distant history. Those assumptions shaped the data that now feeds medical technology. When biased clinical practices form the basis of algorithms, the risk is not hypothetical. The bias can be learned, automated, and scaled.

For us in the Black community, this creates understandable fear and mistrust. Many families already carry generational memories of medical discrimination, from higher maternal mortality to lower life expectancy to being dismissed or unheard in clinical settings. Adding AI biases could make our community even more apprehensive about the healthcare system.

As a physician, I know how much trust patients place in the healthcare system during their most vulnerable moments. As a Black woman, I understand how bias can shape experiences in ways that are often invisible to those who do not live them. As a mother of two Black children, I think constantly about the systems that will shape their health and well-being. As a legislator, I believe it is our responsibility to confront emerging risks before they become widespread harm.

That is why I am the author of Senate Bill (SB) 503. This bill aims to regulate the use of artificial intelligence in healthcare by requiring developers and users of AI systems to identify, mitigate, and monitor biased impacts in their outputs to reduce racial and other disparities in clinical decision-making and patient care.

Currently under consideration in the State Assembly, SB 503 was not written to slow innovation. In fact, I encourage it. But it is our duty must ensure that every tool we in the healthcare field helps patients rather than harms them.

The health of our families depends on it.

About the Author 

Sen. Akilah Weber Pierson (D–San Diego) is a physician and public health advocate representing California’s 39th Senate District.

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Activism

As California Hits Aging Milestone, State Releases Its Fifth Master Plan for Aging

“California’s Master Plan for Aging started a powerful movement that is shaping the future of aging in our state for generations to come,” Gov. Gavin Newsom said in a statement, calling the initiative a “future-forward” model delivering real results for older adults, people with disabilities, and their families.

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iStock.
iStock.

By Bo Tefu, California Black Media  

On Jan. 27, California released its Fifth Master Plan for Aging Annual Report,titled “Focusing on What Matters Most,” outlining the state’s progress and priorities as its population rapidly grows older.

The report, issued by the California Health and Human Services Agency (CalHHS), provides updates on the Master Plan for Aging’s “Five Bold Goals”: housing, health, inclusion and equity, caregiving, and affordability.

The report comes as Californians aged 60 and older now outnumber those under 18 for the first time, a demographic shift expected to accelerate over the next decade.

“California’s Master Plan for Aging started a powerful movement that is shaping the future of aging in our state for generations to come,” Gov. Gavin Newsom said in a statement, calling the initiative a “future-forward” model delivering real results for older adults, people with disabilities, and their families.

Launched in 2021, the Master Plan for Aging takes a “whole-of- government” and “whole-of-society” approach, coordinating state agencies, local governments, community organizations, and private partners. The annual report highlights significant milestones, including more than 100 California communities joining AARP’s Age-Friendly Network and $4 million in state funding awarded to local organizations to develop aging and disability action plans in 30 communities statewide.

The report also underscores California’s leadership at the national level, noting that dozens of states have followed its example and that federal legislation inspired by the plan was reintroduced in the U.S. Senate in December 2025.

CalHHS Secretary Kim Johnson emphasized the plan’s focus on equity and resilience amid ongoing challenges.

“The Master Plan for Aging continues to provide a vision, a focus, and a platform for collaboration,” Johnson said. “Equity is at the center of all that we do.”

Looking ahead, the report notes that by 2030, one in four Californians will be age 60 or older, positioning the Master Plan for Aging as a central framework for meeting the state’s long-term social, economic, and health needs.

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Community

Candidates Vying for Governor’s Seat Debate at Ruth Williams–Bayview Opera House in San Francisco

The gubernatorial debate participants included Antonio Villaraigosa, former Los Angeles mayor; Matt Mahan, San Jose mayor; Betty Yee, former California state controller; Xavier Becerra, former U.S. Secretary of Health and Human Services, and attorney general of California; Steve Hilton, political commentator and political adviser; Tom Steyer, entrepreneur, and Tony Thurmond, California’s superintendent of public instruction.

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The gubernatorial debate was hosted by KTVU’s Greg Lee, KTTV’s Marla Tellez and KTVU’s Andre Senior. The candidates are (l.-r.): Xavier Becerra, Steve Hilton, Matt Mahan, Tom Steyer, Tony Thurmond, Antonio Villaraigosa, and Betty Yee.
The gubernatorial debate was hosted by KTVU’s Greg Lee, KTTV’s Marla Tellez and KTVU’s Andre Senior. The candidates are (l.-r.): Xavier Becerra, Steve Hilton, Matt Mahan, Tom Steyer, Tony Thurmond, Antonio Villaraigosa, and Betty Yee.

By Carla Thomas 

 

On Tuesday, Feb. 3, seven candidates took the stage at the historic Ruth Williams–Bayview Opera House in San Francisco for the gubernatorial debate, hosted by the Black Action Alliance (BAA) in partnership with KTVU and sister station KTTV Fox 11 in Los Angeles.

 

For many voters, it marked a first opportunity to hear directly from several candidates seeking to lead the nation’s most populous state.

 

The gubernatorial debate participants included Antonio Villaraigosa, former Los Angeles mayor; Matt Mahan, San Jose mayor; Betty Yee, former California state controller; Xavier Becerra, former U.S. Secretary of Health and Human Services, and attorney general of California; Steve Hilton, political commentator and political adviser; Tom Steyer, entrepreneur, and Tony Thurmond, California’s superintendent of public instruction.

 

Crucial topics and issues addressed throughout the debate included housing, crime, immigration, climate change, health care and homelessness.

 

The debate was moderated by KTVU political reporter Greg Lee alongside KTVU’s Andre Senior and KTTV Fox 11’s Marla Tellez.

 

Candidates also addressed inflation and the rising costs across the state, impacting everything from groceries to childcare and health care. 

 

Thurmond vowed to generate 2.3 million units of housing by placing 12 units on each parcel of available land in the 58 counties of California. Steyer agreed that billionaires should pay their fair share of taxes.

 

Hilton wanted to cut taxes, help working-class families, and end the Democrats “climate crusade and insane regulations.”

 

Yee offered a more transparent governmental approach with accountability, given the state’s debt.

 

Gonzalez said, “This debate was a great way to see who has great ideas and who has substance.”

 

“It’s important to have the debate within a community that requires the most,” said business leader Linda Fadekye.

 

Attendees included State Controller Malia Cohen, representatives of the National Coalition of 100 Black Women, the National Coalition of 100 Black Men, the San Francisco African American Chamber of Commerce, and Black Women Organized for Political Action, among others. 

 

Event host, the Black Action Alliance (BAA) was established to amplify the voices of the Bay Area’s Black community, whose perspectives have too often been overlooked in politics and public policy.  

 

Loren Taylor, CEO of BAA, said it was important to bring the event to the Bayview in San Francisco and shared his organization’s mission.

 

“The Black Action Alliance (BAA) stands for practical, community-driven solutions that strengthen public safety, address homelessness, support small businesses, expand affordable housing, and ensure access to quality education—issues at the heart of the Black experience in the Bay Area,” said Taylor. 

 

California’s primary election will take place on June 2 and the general election will take place on Nov. 3. 

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