A Force in the Fight for Juvenile Health Care Coverage in California—Benji Plener ’09
We learned that California youth coming out of juvenile detention facilities were losing their state health care coverage. These kids could be detained for a few weeks—or even a few days—and end up with no health insurance. It’s pretty to easy to see why this is bad policy. Youth in the juvenile justice system suffer disproportionately from mental health issues and substance abuse problems. It’s critically important that these kids have continuous access to health care at this particularly vulnerable point in their lives. There are a lot of things the state could do to improve the chances for these kids and enhance the safety of their communities. Cutting off their health insurance is not one of them.
As we researched this issue, we discovered that this policy is not just unwise—it is illegal. As a participant in the federal Medicaid program, California has an obligation to cover all approved services for each eligible patient. And while federal law excludes most services during a juvenile’s period of detention, full federal coverage turns back on at the moment of release. By terminating the health insurance of these kids and refusing to reinstate that coverage upon their release, California is violating its obligations under federal law.
I was asked to develop a litigation strategy for this issue. I wrote a memo outlining the legal arguments and suggesting how the City of San Francisco could try to remedy the situation. The City is the ideal litigant here for a few reasons. Since these kids are going in and out of the system all the time, it’s really hard for any individual juvenile to challenge this policy in court. But the City is able to see the big picture and challenge this policy on behalf of all the juveniles affected. After all, the City itself is affected by this policy: when these kids have no access to health coverage from the state or federal government, the City must step in to address their medical needs.
At the end of my summer internship with the Task Force, we presented a litigation proposal to Dennis Herrera, the City Attorney, and he gave the project the green light. A few weeks later, the office had filed a petition for writ of mandate in state court asking a California judge to order the state to change its illegal policy. The state responded by disputing all our arguments about why these kids had to have health coverage upon release, but this past spring, the state judge rejected these arguments and concluded that we could proceed with our suit.
To my mind, this case demonstrates what’s so exciting about affirmative litigation at the city level. We were faced with a problem that nobody else could address. And once the City identified an appropriate strategy, things moved remarkably fast. I am one of the few lucky students in the Law School who has been able to participate in a litigation project from conception to proposal to court filing to ruling to (hopefully) a satisfactory and important resolution. It doesn’t get much better than that.
Read related story, “YLS Students Helped Prepare Case Detailed in Business Week.”