New Brief Unpacks How States Can Leverage Medicaid Funds to Expand School-Based Health

It’s been five years since the Centers for Medicare and Medicaid Services (CMS) opened the door to more Medicaid reimbursement for health services delivered in schools. School districts, once restricted to seeking reimbursement only under very specific conditions, were permitted to cover all eligible services delivered to all Medicaid-enrolled students. Put simply, this means more health care funding for the most disadvantaged students.

Healthy Schools Campaign’s new brief, Schools Are Key To Improving Children’s Health: How States Can Leverage Medicaid Funds to Expand School-Based Health Services, looks at the connection between health and education and how states are leveraging this new opportunity.

The brief found significant momentum. Ten states—Connecticut, Kentucky, Louisiana, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, North Carolina and South Carolina—have successfully expanded their school-based Medicaid programs, four of them in 2019 alone, with more states working to do so. Schools that have expanded Medicaid in this way report improved and expanded access to care for students enrolled in Medicaid and increased, sustainable revenue and reimbursement for schools.

Why is expanding access to school health services important? There is an undeniable connection between a child’s health and his or her readiness to learn. Left untreated or undermanaged, health issues can adversely affect children’s attendance, their ability to see, hear and pay attention in the classroom, their ability and motivation to learn, and even their chances of graduating from high school.

In addition, students in underserved communities, particularly students of color, are at increased risk of chronic health problems such as diabetes and asthma that can hinder learning and have a significant impact on long-term health. Ignoring these health inequities will undermine efforts to close the opportunity gap.

Schools—and school health and behavioral health providers—can play a critical role in supporting the health and school readiness of children. Schools are increasingly seen as places to deliver high-quality, cost-effective healthcare. Numerous studies show that access to school nurses and other school health providers can improve health and reduce absenteeism, particularly for students with chronic health issues. Increased access to school health services is also a proven strategy for improving academic outcomes.

Unfortunately, many school districts lack the necessary resources to support all the health care needs of their students. To support school districts and improve student health, there is growing interest in leveraging Medicaid funds for school-based health services.

Through this work, Healthy Schools Campaign has learned lessons that are worth repeating about what it takes to advance collaboration among schools, departments of education and Medicaid. It is important to:

  • Collaborate across sectors and advocates
  • Collect data
  • Align efforts with healthcare transformation
  • Create a policy environment that supports the interactions between health and education
  • Leverage existing assets
  • Engage advocates

Healthy Schools Campaign, in partnership with the Trust for America’s Health, also released a Guide To Expanding Medicaid Funded School Health Services, for advocates who want to explore more about the nitty-gritty of what it takes to move forward in expanding Medicaid.

Working together, advocates and state and local policymakers can advance state policy that promotes health and education—and can draw on federal Medicaid resources to sustain it.

Lena O’Rourke is a consultant for the Healthy Schools Campaign, and Alex Mays is the campaign’s senior national program director.