Dive Brief:
- Eight in 10 school district staff predict reductions and layoffs of school health personnel if Congress cuts federal funding for Medicaid. Another 90% said Medicaid cuts would cause district budget reductions even to programs outside of school health services, according to survey results released March 12 by Healthy Schools Campaign.
- The highest percentage of districts — 86% — use Medicaid funds for school and district health staff salaries. The next highest percentage — 59% — said the funds support contracted services for mental and behavioral health.
- Congress does not yet have a specific plan to trim Medicaid reimbursements or eligibility. Republican leaders, however, are attempting to drastically cut federal spending, which Democratic lawmakers and public health benefit advocates say would likely be aimed at Medicaid.
Dive Insight:
At $7.5 billion annually, Medicaid is the 4th largest federal funding stream for school districts, according to the report. Without Medicaid funding, state and local education funds would need to cover these costs, the report said.
About 40% of children under 18 — or about 30 million — rely on Medicaid for physical, behavioral and mental health services.
Schools providing health services for students with disabilities can seek Medicaid reimbursement to help pay for those supports in most states. Additionally, schools in some states can get reimbursed for Medicaid-covered health services provided to all students enrolled in the public health program.
Survey respondents noted that decreased Medicaid dollars would lead to school budget deficits, because schools would still be required to provide some health services that are mandated for students with disabilities. To fill budget gaps, some who were surveyed predict increases to local property taxes.
In Michigan's Monroe County Intermediate School District, which is comprised of nine constituent public school districts, Medicaid expansion in the state has allowed the public school districts in the system access to eight mental health consultants, said Shawna Dippman, supervisor and planner/coordinator in MCISD, during a recent webinar by Healthy Schools Campaign.
The expertise is needed, Dippman said. This school year, there have been 255 referrals for mental health services. Since September 2021, there have been just under 1,000 referrals, she said. The top referral reasons this school year are depressed mood, anxiety, negative life events and trauma. MCISD has about 19,500 students, Dippman said.
She added that the county is "extremely fortunate" for the expertise of the mental health consultants who navigate referrals and services.
About 1,440 school district staff and officials from all 50 states and the District of Columbia responded to the survey published by Healthy Schools Campaign. Of those responses, 45% were from rural districts, 34% came from suburban districts, and 17% were urban. Respondents included roles such as superintendents, special education administrators, school business officials, school Medicaid coordinators and school nurses.
The National Alliance for Medicaid in Education, Council of Administrators of Special Education, Association of School Business Officials International, and AASA, The School Superintendents Association contributed to the survey research.
