Proposed Medicaid cuts will hurt schools, district leaders say

Dive Brief:

A new nursing services reimbursement program in Georgia that could double the number of school nurses in the state was approved by the state’s Education Department and Department of Community Health this week, with a proposed $48.6 million in federal funding expected to come from Medicaid, according to The Atlanta Journal-Constitution.
The move comes as legislation on whether to repeal and replace the Affordable Care Act is debated by Republicans in the U.S. Senate, and as the proposed bill currently stands, Medicaid payments could be reduced over time and Medicaid expansion made possible through the ACA could be affected — though no one could say how such changes would affect Georgia’s proposal.
The funding is available for schools that serve populations qualifying for Medicaid, as school nurses may often be the only medical practitioner students see regularly, particularly in rural areas — though it could also be difficult to find 2,000 nurses to fill the open positions if the funding is approved.

Dive Insight:

Between 2013 and 2015, the percentage of uninsured children dropped from 7.1% to 4.8%, and the Medicaid expansion under the Affordable Care Act enabled schools to utilize more funding for health services, including special education services and mental health services.

Many school and district leaders are concerned about the immediate and prolonged impact of an ACA repeal. According to the Center for American Progress, Medicaid spending accounts for about $3 billion in funding for schools nationwide each year — the Individuals with Disabilities Education Act, by comparison, is responsible for $13 billion per year. But it's not only direct appropriations to schools that may be impacted. If students lose access to healthcare at home, pressure on school nurses, already being cut in many districts, could increase, and more schools could find themselves having to include medical care to their suites of wraparound services offered to help remove distractions from learning.

“The projected loss of $880 billion in federal Medicaid dollars under the House bill and the Senate’s proposal to reduce Medicaid to a mere shell of itself is unconscionable,” Superintendent Gregory Hutchings of Shaker Heights, OH, said about the proposed legislation. Superintendent Gary Kelly from DuQuoin, IL, said that if schools were not able to access Medicaid funding as they can now, the schools are "going to be hurting kids."

School and district leaders could consider holding information sessions with parents regarding the potential impact a repeal of the ACA and a loss of Medicaid expansion funding could have on health services at the schools. Such a step would demand caution, as the ACA repeal is an extremely politicized issue in a country that is plagued by rancorous partisan divides, but school leaders could frame it as a way to remove politics from the situation and help parents better discern what the implications could be. Such outreach could lead to pressure on lawmakers to consider what the ramifications of the Senate and House legislation could be.