They are often the victims of physical or mental abuse by their parents, get bounced like a ball from one foster family to another, and sometimes wait between five to eight years to get adopted. Some never find a permanent home.
The plight of the nation's foster care children has moved President Clinton to give the Health and Human Services Department 60 days to double the adoptions and permanent placements of foster care children by the year 2002.
But while adoption experts applaud Clinton's actions, many say achieving his goal will require significant reforms of the foster care system, an effort that may prove difficult because of the entangled bureaucracy, entrenched attitudes, and competing interests involved. And some suggest Clinton's mandate is not ambitious enough.
"I wish the president had set the bar higher," says Maureen Hogan, executive director of Adopt a Special Kid/America, the nation's oldest special needs adoption organization. "This is an infinitesimal response to a huge problem."
Some experts contend part of the challenge is that little data exists on what states are or aren't doing a good job in getting kids placed. Spotty reporting by agencies compounds the problem.
According to Ms. Hogan, the administration's calculation of children in foster care is too low. She estimates the figure at 600,000, and says only about 14,000 get adopted each year. "This is dismal. We can place many more of these kids in adoptive homes than we're placing now - 55,000 ... are legally free to be adopted today."
The reasons why more foster children aren't being adopted vary from controversial laws to abuses of the system.
One barrier is the practice of matching children only with members of their own race. Though a law was passed last August forbidding the use of race to deny adoption, it has been given little more than lip service and traps many children in foster care, says Elizabeth Bartholet, a Harvard University professor who teaches family and adoption law. "That law could do a lot to free kids ... but it's going to take strong enforcement from on high," she says. "Over half of kids in foster care are (minority), and the social work system is adamantly committed to keeping them there unless race families can be found."
Another obstacle to adoption is family preservation, based on the principle that every effort should be made to keep children with biological parents. When the parent is abusive or has a substance-abuse problem, the child is placed in foster care and waits there - sometimes for years - until the parent is deemed fit to resume responsibility.
The problem, says Bill Pierce, president of the National Council For Adoption in Washington, is that in some areas 30 percent of the children reunited with their biological families are later returned to foster care because of continued abuse. "That's a 30 percent failure rate," he says.
Finally, some charge that lucrative subsidies make kids hostage to the foster care system. "There are some very powerful financial incentives to keep children in foster care rather than place them in adoptive homes ... federal subsidies to subsidize their care, which go away if the kids are placed," Hogan of AASK/America says.
"Right now a huge amount of money reverts to the agencies that administer foster care with only a small amount ... trickling down to foster families and the children."
Some estimate the numbers of foster children has doubled over the past decade, and predict they will increase because of welfare reform. Others say the welfare system has been bad for kids because it has given money to parents unconditionally, even when they are drug or alcohol addicts.
Groups such as AASK/America say that in addition to system reform, steps can be taken to make adoption easier. The group advocates a national database of waiting children and prospective parents to facilitate matching and the elimination of county to county and state to state barriers to placement.
"There are waiting lines even for very seriously disabled children," Professor Bartholet says.
"It's also a question of education," Hogan says. "There's a lot of misconceptions of adoption in this country," such as it's expensive and people have to shell out a lot in medical bills if children have physical problems. "The most important thing is getting the word out to the average person that you don't have to be rich, you don't have to worry about paying the medical expenses (because of Medicaid coverage)."
The recipe for reform is simple, she adds: "It's the public agencies letting the kids go when it's time, and it's letting families know at a grass-roots level that this is accessible to them."