Source: United States House of Representatives – Julia Brownley (D-CA)
Washington, DC – Today, Congresswoman Julia Brownley (D-CA) and Congressman Gus Bilirakis (R-FL) introduced the Ensuring Medicaid Continuity for Children in Foster Care Act of 2026—commonsense, bipartisan legislation to ensure vulnerable children do not lose access to essential mental health care because of a bureaucratic technicality.
Children in the foster care system have often endured severe trauma, abuse, or neglect. Many rely on specialized, around-the-clock care to begin healing. Congress recognized this need when it passed the Family First Prevention Services Act of 2018 (FFPSA), which created Qualified Residential Treatment Programs (QRTPs)—high-quality, trauma-informed settings designed to provide comprehensive mental and behavioral health services to children with the most complex needs. But due to a technical interpretation by the Centers for Medicare and Medicaid Services (CMS), many of these programs are being treated as Institutions for Mental Disease (IMDs) simply because they serve more than 16 individuals. As a result, children placed in these appropriate, clinically recommended settings can lose access to Medicaid coverage for the very services they depend on. In plain terms, this means that a child who has already experienced significant trauma could be denied care—not because it isn’t needed, but because of how a facility is categorized on paper.
The Bilirakis-Brownley bill fixes this problem by ensuring that QRTPs are not unfairly classified as IMDs, as long as they meet the rigorous standards and accreditation requirements established under FFPSA. This targeted solution preserves accountability while ensuring that children can continue receiving the care they need, when and where they need it.
“Children in foster care deserve stability and consistent access to the mental and behavioral health services that support their well-being,” said Congresswoman Julia Brownley. “Yet because of how certain programs are classified, children placed in clinically appropriate settings can lose access to Medicaid coverage for the very care they rely on. That is a failure of our system. This legislation fixes that gap, strengthens continuity of care, and ensures foster youth can access the services they need without disruption. We have a responsibility to ensure no child’s health, stability, or future is put at risk by outdated policy, and to make sure every child has the support they need to thrive.”
“No child should lose access to critical mental health care because of a bureaucratic definition,” said Congressman Bilirakis. “Most children who enter the foster care system have already experienced unimaginable trauma. The last thing we should do is put up barriers to the care that can help them heal. This legislation ensures continuity of care in the settings best equipped to meet their needs. I am proud to work in a bipartisan manner to fix this unintended roadblock and ensure these children receive the support and services they deserve.”
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Issues: 119th Congress, Healthcare