Medicaid’s Vital Role for Schools and Students

It feels like summer just arrived, but back-to-school time is near! Before the back-to-school bell rings, we wanted to take stock of health coverage for school-age children.  

As SayAhhh! readers are well aware, Medicaid and 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. Our new report unpacks health coverage for school-age children using data from the American Community Survey. This report is similar to our annual report on uninsured children, but focuses on specifically on school-age children (6 through 18), instead of all children under 18.

Here’s what we found:

  • The rate of uninsured school-age children declined by nearly half between 2009 and 2016.
  • About 37 percent of all school-age children and 79 percent of school-age children living in poverty are enrolled in Medicaid or CHIP.
  • 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.
  • 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).

Children need health coverage to help them stay healthy and ready to learn in the classroom. We previously highlighted research showing that health coverage can reduce school absenteeism by increasing children’s physician visits and overall health. We also know from the longitudinal research that Medicaid may lead to children’s education and economic success in adulthood, even making the difference in whether a child graduates from high school or college.

Medicaid plays a particularly important role in school districts that have a large share of their students covered through Medicaid. Data are available on our website on the share of children covered through Medicaid living within the boundaries of a school-district. In the report, we present data for the ten largest school districts (copied below).

Schools across the country benefit from Medicaid. Many schools that serve Medicaid-enrolled children 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. Most superintendents report that Medicaid makes it possible to meet special education mandates (and program cuts would make that much more difficult!). Medicaid spent about $4 billion on school-based health care services in 2015 (see this appendix table for more state-by-state information).

Medicaid’s role maintaining coverage gains, filling gaps, and supporting long-term educational outcomes for children depends on the strong engagement of health and education policy leaders. National, state and school level leaders can work together to keep public coverage strong, ensure children are enrolled in Medicaid/CHIP, and prioritize coverage outreach efforts where gaps persist.