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

Introduction : Youth with child welfare involvement face unique challenges associated with transition into adulthood and access to healthcare once they exit foster : care. Methods: Using longitudinal data between 2012 and 2022 from the Jim Casey Opportunity Passport Survey, this study explored if sociodemographic characteristics of foster youth alumni ( n = 2,420) were associated with differences in insurance coverage over time, and if foster youth alumni without insurance were more likely to forgo health care when needed. Results : Youth without insurance had lower odds of not seeking physical or health care even when they perceived a need. The overall likelihood of having health insurance coverage decreased over time for those assigned male at birth but not for those assigned female at birth. Results further indicate that Black, Indigenous and other People of Color (BIPOC) foster youth alumni were less likely to report having insurance relative to non-Hispanic White peers, and that LGBTQ + foster youth alumni assigned male at birth were more likely to be insured than their non-LGBTQ + male peers. Implications : Strategies for increasing health equity in relation to practice and policy are explored.