A longitudinal study of differences in health insurance coverage for foster youth alumni.

This article examines health insurance coverage and healthcare access among foster youth alumni in the United States, using longitudinal data from the Jim Casey Opportunity Passport Survey collected between 2012 and 2022. Findings indicate that having health insurance significantly reduces the likelihood of forgoing needed physical or mental health care among this population. Sociodemographic factors such as race/ethnicity, sex assigned at birth, LGBTQ+ identity, reason for exit from care, and state-level policies—including Medicaid expansion and protections for LGBTQ+ individuals—are associated with differences in insurance coverage over time. Specifically, Black, Indigenous, and other People of Color (BIPOC) foster youth alumni were less likely to have insurance compared to non-Hispanic White peers, while LGBTQ+ individuals assigned male at birth were more likely to be insured than their non-LGBTQ+ male counterparts. The study highlights the importance of expanding Medicaid eligibility, increasing culturally competent healthcare, and implementing affirming policies to improve health equity for foster youth alumni.