Kansas stories: Doug & Jake

May 2024

Doug is a teacher who lives in Lawrence with his adopted son Jake.

Doug opened his heart and his home to a child in need and adopted Jake out of foster care. Like all other kids adopted out of foster care, Jake was covered under Medicaid until he turned 18. This is a standard part of adoption agreements when children come from foster care in Kansas.

Doug had hoped that once Jake turned 18 he would be able to begin his life as a young adult and work towards supporting himself and being fully independent.

But because of the childhood trauma he experienced, including severe Post Traumatic Stress Disorder (PTSD), Jake struggles to maintain steady employment. He has responded well in the past to therapy and medication, but since he lost his health insurance he can no longer access the mental health care he needs.

During the COVID-19 pandemic Jake was able to keep his Medicaid coverage. But once the public health emergency ended and redeterminations began again, Jake lost his health insurance. Because Kansas has not expanded Medicaid, he is uninsured and in the coverage gap.

Doug had retired, but has gone back to teaching in order to help Jake pay for his medical needs.

Doug adopted Jake to give him a stable family environment. He knew Jake may need long-term mental health services, and is now helping Jake apply for disability. But this process can take many years and several appeals, which leaves Jake with very few options right now.

Children who are still in foster care when they turn 18 years old are eligible to remain on Medicaid until they turn 26. But children adopted out of foster care lose Medicaid coverage at 18, despite having many of the same childhood traumas and experiences that need treatment.

Additionally, a 2023 study from the Kansas Health Institute found that states with Medicaid expansion experience a 32% reduction in foster care admissions related to neglect as compared to non-expansion states like Kansas. Applying that to 2022 Kansas foster care data equates to an estimated 305 fewer children entering the foster care system in Kansas because of neglect.

If Kansas had already expanded Medicaid, Doug would have been able to fully retire and Jake would not be living in the coverage gap today. Medicaid expansion is critical for young adults like Jake transitioning into adulthood and learning to be independent, productive adults.

*Doug and Jake are pseudonyms