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District Leaders Warn That Potential Medicaid Changes Could Squeeze Services

By Alyson Klein — February 22, 2018 1 min read

Republicans in Congress may have kicked the can down the road—for now—on ditching the Affordable Care Act.

But advocates for school superintendents, who mobilized against a potential reduction to Medicaid funding last year, are still warning of serious consequences for schools if lawmakers decide to make changes to the program.

Schools receive about $4 billion a year from Medicaid, a health-care program for the poor. That makes Medicaid the third-largest source of federal K-12 funding, behind special education grants and Title I grants for disadvantaged kids.

The money is used for a slew of purposes, among them: vision and hearing screenings, medical equipment, and salaries for staffers who work with Medicaid-eligible students, such as speech therapists. It’s also used to connect students with community health services.

GOP lawmakers have pitched distributing Medicaid funds on what’s called a “per capita” basis, based on how many people a state has from particular groups, including children and the elderly. Fans of this approach argue that it would spur states to think more innovatively about how they structure their Medicaid programs. But detractors, including a lot of education advocates, worry it would mean big cuts to the program over time.

That proposal was part of health care bill that bill that failed to make it over the finish line last year. But isn’t going away just because a Republican health care bill faltered. In fact, it was part of President Donald Trump’s recent budget proposal for fiscal 2019.

So what could that mean for schools? AASA, the School Superintendents Association, surveyed its members last December, asking what would happen if Medicaid were cut. It found that 57 percent of school districts have concerns about meeting special education mandates, 36 percent of districts would have to reduce mental health services, and more than a quarter would have to cut general education funding and positions.

Here’s a graphic from AASA that breaks this down further:

Want more? Check out the report on this topic on AASA’s website.


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