Research & Reports CHIP Medicaid Schools

Medicaid and CHIP Provide Health Coverage for Many School-Age Children, Yet Gaps Remain

July 18, 2018 Karina Wagnerman, Elisabeth Wright Burak

Top Lines

  • Medicaid and CHIP are crucial for ensuring that school-age children (ages 6-18) have access to health care.

In This Report:

Key Findings

  • The rate of uninsured school-age children declined by nearly half between 2009 and 2016. Nevada experienced the largest declines in uninsured school-age children between 2009 and 2016.
  • The rate of uninsured school-age children remains nearly twice as high in states that did not adopt the Medicaid expansion under the Affordable Care Act (7 percent) compared to states that adopted the Medicaid expansion (3.8 percent).
  • Medicaid and the Children’s Health Insurance Program (CHIP) are crucial for ensuring that school-age children (ages 6-18) have access to health care. About 37 percent of all school-age children and 79 percent of school-age children living in poverty receive health coverage through these programs.
  • School-age children are more likely to be uninsured than those under age 6, with 5.1 percent of the older population lacking coverage compared to 3.8 percent of young children.

Introduction

Children need health coverage to help them stay healthy and ready to learn in the classroom. Medicaid and the Children’s Health Insurance Program (CHIP), the primary public health coverage sources for children, have worked together in recent decades to bring the rate of uninsured children to historic lows. In 2016, only 4.5 percent of all children were uninsured.1 Serving 40 percent of all children,2 Medicaid and CHIP help children get the health care they need when they need it. Medicaid’s child-specific benefits requirement (Early and Periodic Screening, Diagnostic and Treatment or “EPSDT”) is designed to ensure diseases and developmental delays are caught and addressed as early as possible, before they disrupt future health and learning.3 Medicaid also provides financial security for families by limiting their exposure to high medical costs, decreasing the chance that they will face onerous medical bills, and reducing the likelihood of medical bankruptcy.4

Medicaid and CHIP help schools do their job. Health coverage can reduce school absenteeism by increasing children’s physician visits and overall health.5 Longitudinal research shows the important role Medicaid can play in children’s education and economic success in adulthood, even making the difference in whether a child graduates from high school or college.6 Studies have shown linkages between Medicaid eligibility increases for children and improvements in reading test scores in the 4th and 8th grades, decreased high school dropout rates, and increased college completion.7

Medicaid also helps schools in more direct ways. Many schools that serve children covered by Medicaid can use the program to pay for child health personnel (e.g. school nurses, therapists, social workers) that provide preventive screenings, therapy, mental health evaluations, or other services.8 Medicaid funds can help to reimburse schools for some of these costs if children are eligible and enrolled. Schools are required to meet the educational needs of all students, including those with special needs. The federal Individuals with Disabilities Education Act (IDEA) requires schools to provide any medical services for children with disabilities that are deemed necessary to their special education plans. Most superintendents report that Medicaid makes it possible to meet special education mandates. About one-third of superintendents say that support from Medicaid for special education needs helps stave off possible cuts to mental health services and/or general education programs and personnel.9

Full Report

Download and read the entire report. 

  1. J. Alker and O. Pham, “Nation’s Uninsured Rate for Children Drops to Another Historic Low in 2016” (Washington: Georgetown University Center for Children and Families, September 2017), available at https://ccf.georgetown.edu/wp-content/ uploads/2017/09/Uninsured-rate-for-kids-10-17.pdf.
  2. Data retrieved from the American Community Survey Fact Finder, “Public Health Insurance Coverage by Type” (Washington: United States Census Bureau, 2016), available at https://factfinder.census.gov/faces/tableservices/jsf/pages/productview. xhtml?pid=ACS_16_1YR_S2704&prodType=table.
  3. Center for Children and Families, “EPSDT: A Primer on Medicaid’s Pediatric Benefit” (Washington: Georgetown University Center for Children and Families, March 2017), available at https://ccf. georgetown.edu/wp-content/uploads/2018/02/EPSDT-Primer-Fact- Sheet.pdf.
  4. K. Wagnerman, “Medicaid: How Does It Provide Economic Security for Families?” (Washington: Georgetown University Center for Children and Families, March 2017), available at https://ccf. georgetown.edu/wp-content/uploads/2017/03/Medicaid-and- Economic-Security.pdf.
  5. S. Zhang, “Do Our Children Become Healthier and Wiser? A Study of the Effect of Medicaid Coverage on School Absenteeism,” International Journal of Health Services 42, no. 4 (2012): 627-646, available at http://journals.sagepub.com/doi/pdf/10.2190/ HS.42.4.d.
  6. K. Wagnerman, A. Chester, and J. Alker, “Medicaid Is a Smart Investment in Children” (Washington: Georgetown University Center for Children and Families, March 2017), available at https://ccf.georgetown.edu/wp-content/uploads/2017/03/ MedicaidSmartInvestment.pdf.
  7. P. Levine and D. Schanzenbach, “The Impact of Children’s Public Health Insurance Expansion on Educational Outcomes,” National Bureau of Economic Research (working paper, January 2009), available at http://www.nber.org/papers/w14671; S. Cohodes et al, “The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions,” National Bureau of Economic Research (working paper, October 2014), available at http://www.nber.org/papers/w20178.
  8. The School Superintendents Association, “Cutting Medicaid: A Prescription to Hurt the Neediest Kids – 2018 Addendum” (Alexandria, VA: The School Superintendents Association, 2018), available at http://www.aasa.org/uploadedFiles/Policy_and_Advocacy/Resources/CuttingMedicaid2018Addendum.pdf.
  9. The School Superintendents Association, “Cutting Medicaid: A Prescription to Hurt the Neediest Kids – 2018 Addendum” (Alexandria, VA: The School Superintendents Association, 2018), available at http://www.aasa.org/uploadedFiles/Policy_and_ Advocacy/Resources/CuttingMedicaid2018Addendum.pdf.

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