By Sean Miskell
Access to quality health coverage for children is certainly important for its own sake, and evidence increasingly suggests the way in which health is connected to other crucial aspect’s of children’s development such as education. A new report from the Education Commission of the States sheds further light on these connections and highlights how children’s health programs can reduce barriers to learning.
We’ve used the fiftieth anniversary of Medicaid as an opportunity to highlight the positive long-term effects of Medicaid coverage, especially on educational outcomes. But while the longitudinal studies that we have noted demonstrate the general effects that Medicaid coverage has on educational outcomes such as high school and college graduation rates, the Education Commission of the States addresses specific programs – including those provided by Medicaid and the Children’s Health Insurance Program (CHIP) – and their role in promoting educational opportunity.
The report notes that the 19 percent of students that do not graduate on time are much more likely to have health barriers to learning, as health problems influence a child’s motivation and ability to learn. This is especially true for low-income and minority youth. In addition to programs specific to schools, such as physical education and school-based wellness centers, the Education Commission of the States highlights the importance of developmental screenings, a topic with which Say Ahhh! readers are likely familiar. Recently, Carrie Fitzgerald of First Focus wrote in Say Ahhh! about the importance of developmental screenings and state-level initiatives to encourage them.
Developmental screenings are an important aspect of both Medicaid and CHIP coverage. Medicaid and CHIP benefits include the Early and Periodic Screening, Diagnostic, and Treatment benefit (EPSDT), which provides comprehensive and preventive health care services for children under age 21. States have the ability to set their own periodicity schedule for developmental screenings in EPSDT, and many states incorporate Bright Futures, a set of guidelines for developmental screenings developed by the American Academy of Pediatrics into their standards. Nonetheless, the Education Commission of States notes that “almost nine million children did not see a health care provider for preventive medical care in the past 12 months, and thus do not benefit from these screenings.” The report calls for national minimum standards to provide incentives for schools to have proof of screenings that help identify and manage health barriers to learning for their students. We have also drawn attention to the additional work that both states and the federal government must do to ensure that children receive developmental screenings, especially those enrolled in Medicaid or CHIP.
Another key issue the report highlights is the need to incorporate health data into school accountability metrics and to draw connections between children’s health and educational data. At CCF we will always cheer on calls for more and better data, and our own Tricia Brooks recently wrote about recommendations to improve the Child Core Set of Health Care Quality Measures within CHIP. The Education Commission of the States’ call to make connections between health and educational data is also a step in the right direction.
While there is much more to do to reduce health barriers to learning, the report argues that implementing healthy interventions that can reduce these barriers to learning “simply requires modifications to practices and structures already in place.” In this context, it is important to understand the way in which programs to identify and address children’s health issues are already embedded in current policies and programs like Medicaid and CHIP, and how to ensure that children receive these benefits. This is especially true as lawmakers consider changes to the both CHIP and policies related to the Affordable Care Act’s health insurance marketplaces, especially since plans available through the marketplace often entail pediatric benefits that are not as robust as Medicaid and CHIP’s EPSDT benefits.
