Medicaid and the Children’s Health Insurance Program (CHIP) provide essential health care coverage to more than 40 million children living in the United States. Research shows that Medicaid improves children’s education outcomes, including grade performance and graduation rates, and leads to better health outcomes in adulthood.
Right now, schools and families are strained with surging seasonal illnesses like respiratory syncytial virus (RSV) and the flu, along with the ongoing threat of COVID-19. Thankfully, the Medicaid program and schools actively work together to ensure children stay healthy inside and outside the classroom — a critical task as illnesses that impact children are spiking.
Schools play a critical role in helping children enrolled in Medicaid access the services they need. Schools also help children and families eligible for Medicaid to enter the program. In turn, Medicaid strengthens schools’ health care capabilities and infrastructure for all students.
Medicaid’s School-Based Services
Medicaid covers various services that are provided through schools to students. This includes services performed by school-based health centers, such as:
- Preventive care (e.g., immunizations)
- Oral health care
- Behavioral health care
- Routine health screenings
- Acute care services (e.g., treatment for asthma, diabetes)
Medicaid’s Early Periodic Screening Diagnostic and Treatment benefit also plays a vital role for students with Medicaid, covering medically necessary supplies and equipment they might need to be successful in school, such as hearing aids, eyeglasses, wheelchairs, and other assistive technology.
Providing Services to Students with Complex Health Care Needs
Medicaid ensures that students with more complex needs receive high-quality care, covering services that are provided to children through an individualized education plan (IEP) under the Individuals with Disabilities Education Act (IDEA). IEPs often include services that Medicaid covers for children, including physical or speech therapy.
Since the enactment of IDEA in 1975, the government has not properly funded the resources for schools to provide students with the services they need. Medicaid has helped fill the gap in funding, supporting schools’ ability to effectively carry out students’ IEPs with no cost to children and their families.
Helping Children Enroll in Medicaid
Beyond serving as a resource for Medicaid-enrolled children and students with IEPs to facilitate access Medicaid health services, schools are an important pathway for children and their families to enroll in Medicaid and CHIP.
Schools are trusted places that are often geographically accessible and have established information-sharing methods that can help uninsured children enroll in Medicaid. A majority of school superintendents report that they have taken steps to increase Medicaid enrollment of children in their schools.
Importance of a Strong Medicaid Program for Children in Schools
Medicaid school-based services increase health equity and help vulnerable students receive the care they need. Medicaid helps schools strengthen their health-related services, supplies, and programs to ensure all students, not just those enrolled in Medicaid, receive strong and sustainable care.
When the Medicaid maintenance of eligibility requirements expire in April 2023, it is estimated that 6.7 million children are at risk of losing their Medicaid coverage – putting their health, development, and success in school at risk. Schools and Medicaid programs across the country can collaborate and serve as important resources for children and their families to prevent any disruption to coverage.
The Modern Medicaid Alliance urges state policymakers and Medicaid officials to ensure a smooth transition back to normal operations for eligibility redeterminations, including following redeterminations processes that ensure that millions of children who rely on Medicaid for affordable, high-quality care will not lose coverage inappropriately. In order to achieve this goal, states should follow redetermination guidance from the federal Center for Medicaid and CHIP Services.
For more on the importance of Medicaid in schools, check out our Medicaid Spotlight about the Healthy Students, Promising Futures Learning Collaborative, led by Modern Medicaid Alliance partner Healthy Schools Campaign.