Blog: The Educated Reporter

Five Things to Know About Medicaid and Schools

Despite all of the legislative stops and starts, the Republican-led effort in Congress to overhaul the nation’s health-care system continues.

While it is impossible to predict what shape a “final” health-care bill could ultimately take, nearly every proposal has included a major restructuring of Medicaid — a program that public schools across the country rely on to help provide special education and health services.

A recent Education Writers Association webinar explored the stakes for schools and students in current efforts to overhaul Medicaid.

As the debate continues, here are five things to know about Medicaid and schools:

1. Public schools receive $4 billion to $5 billion in Medicaid funds each year.

As Education Week reports, Medicaid is the third-largest federal program that provides funding to public schools. Schools use these funds to pay for services and equipment for students with disabilities as well as to provide health support and screening to low-income students. Speech and physical therapy, vision and dental screening, wheelchairs, and even buses are paid for, at least in part, through Medicaid.

Medicaid funds also help to pay for school nurses, counselors, social workers, and therapists.

2. House and Senate legislation to revamp the health-care system has included significant changes to the structure and funding of Medicaid.

While some argue that decreasing Medicaid funding and making it a block grant would spur states to be more innovative in using the money, school leaders and special education advocates have expressed concern about the potential impact on schools.

That’s because…

3. With fewer Medicaid dollars flowing to states, school districts and states would likely be forced to make a difficult choice.

That choice is whether to maintain current levels of funding for special education and health services by making cuts elsewhere in their budgets, or find ways to decrease expenses without cutting services to students with disabilities.

Public schools are required by federal law to provide special education services. They receive roughly $13 billion per year through the Individuals With Disabilities Education Act (IDEA) to do that. However, federal IDEA funding does not cover all, or even half, of the cost to educate children with disabilities, so schools and states must find other financial sources to fill the gap. The $4 billion to $5 billion in Medicaid reimbursements schools receive annually is one such source.

4. Higher education could also feel the impact of changes to Medicaid.

As Andrew Kreighbaum of Inside Higher Ed reports, higher education groups worry that “the pressures [Medicaid] reductions would put on state budgets likely will lead to less support of public higher education.”

In addition, teaching hospitals could feel the squeeze if Medicaid funding is decreased. That’s because, with less people covered by Medicaid, these hospitals would likely have to provide more uncompensated care — a burdensome expense for these institutions.

5. Medicaid funding is likely to be a recurring fight at the federal and state levels.

Even if the current effort to overhaul Medicaid fails, lawmakers may take other actions to curtail or restructure the multibillion-dollar, state-federal partnership.

The House Republican budget proposal released this month, for example, would make significant funding cuts to the program.

Advice for Journalists

Kimberly Hefling of Politico and Elisabeth Wright Burak of Georgetown University participated in the EWA webinar this month and offered tips and story ideas for journalists covering this ongoing issue.

While Medicaid may not typically be on the radar for education reporters, “there is a gold mine of stories just looking at how these funds are being used,” Hefling said.

She suggested, in particular, that journalists look at the issue from the perspective of rural communities — many of which supported President Trump but could be impacted in more ways than one from a rewrite of the Affordable Care Act.

“If you talk to superintendents in some of these rural areas, they’ll say ‘not only are we worried about possibly losing staff members who are funded through these Medicaid funds, we’re also concerned about how this will affect hospitals,’” Hefling said.

“In some of these communities, the school districts and the hospitals are the largest employers,” she said.

Hefling suggested that reporters talk with superintendents as well as educators who provide special education services to get their take on what the health-care legislation might mean for them and their students. This is a particularly timely angle given a U.S. Supreme Court decision earlier this year, which ruled that students with disabilities are entitled to a higher standard of educational benefits than what had previously been used.

And, to help make the link between education and health care more vivid, reporters should know about the latest research on the topic, Wright Burak said.

“One of the things that is new in the last few years is some longitudinal research which … has shown that kids who receive Medicaid are more likely to graduate from high school, more likely to graduate from college, and earn higher wages as adults,” she said.

Watch the Replay:

Five Things to Know About Medicaid and Schools