Medicaid and special education services

Four months ago I started this blog with the hope of bringing current topics in education to the forefront to expand readers’ knowledge and demonstrate how they impact all of us. This is a big one. There was a story released this week about the Republicans effort to repeal and replace the Affordable Care Act (ACA). This is very disturbing.

According to the American Association of School Administrators (AASA) Republicans, led by House Speaker Paul Ryan want to reduce federal Medicaid spending by 25% by distributing the funding through a “block grant or a per capita cap, which would shift costs to states… A block grant means that districts may no longer receive a dedicated source of funding based on the services they are reimbursed for providing to students. Instead, schools would be forced to compete with hospitals, doctors, urgent-care clinics and other health-care centers to ensure continued reimbursement.”

This will have a detrimental impact on public schools, specifically students who receive special services.

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Under the Individuals with Disabilities Education Act (IDEA), Medicaid has allowed payments to certain services offered under IDEA. These services include health care screening, diagnosis and treatment services, vision and hearing screenings. Additionally Medicaid covers nurses, therapists and other personnel that provide services for students with disabilities and critical health services to students in poverty.

“Since almost 50 percent of Medicaid beneficiaries are children, providing health and wellness services and services that benefit students with disabilities ultimately
enables more children to become employable and attend higher education” (AASA, 2017).
When asked how the per-capita or block grants would affect students in their districts, school administrators had this to say:
  • “This would lead to reduced services for children with disabilities especially children with significant cognitive and motor delays.”
  • “Our Medicaid funding is used to help pay the salary of skilled therapists needed to fulfill the IEP requirements of our school age children. We live in a very rural area with a shortage of skilled, qualified therapists (Physical, Occupational, Speech). To meet the needs of our students, we supplement their rates with our Medicaid money.”
  • “A reduction in federal funding that effects Medicaid funding would be devastating for providing services to students with disabilities. Medicaid funding closes the resource gap between IDEA, State and local dollars” (AASA, 2017).

When asked how the per-capita or block grants would affect a district’s ability to remain in compliance with the requirements of IDEA, school administrators had this to say:

  • “A 30 percent cut in Medicaid reimbursement would seriously impact our ability to continue to provide special education supports and services. We would have to reduce the number of para-educators in our district, thereby compromising IEP services and leaving us open to legal action.”
  • “Losing 30 percent of our reimbursement would lead us to being unable to hire additional teachers to meet these needs, because we don’t have the funding to take on both the 30 percent and the need for additional staff to meet the needs of students. This would increase caseloads for special education teachers beyond where they are (which is currently understaffed) which will lead to watered down special education services for students, and not as many students making progress on their IEP goals” (AASA, 2017).

When asked how the per-capita or block grants would affect students in poverty, school administrators had this to say:

  • “Without this service in our schools, many students would go without health care as their parents are unable to find, pay for, or get their child to critical services.”
  • “Our district utilizes our Medicaid funding to provide more services for students that have a lack of immunizations, mental health concerns as well as screenings for physical development, anticipatory guidance, vision, dental, hearing. If Medicaid
    funding was reduced, the students in Early Childhood through grade12 would receive less care and services that allow them the ability to learn. The impact would greatly increase our absenteeism as well as put students at risk for lower academic
    achievement” (AASA, 2017).

The advocacy we have seen since the election is unprecedented in my lifetime. We cannot stop. Consider the short and long term ramifications these cuts to Medicaid will have on children, teachers, parents, and in the long term – communities.  Tell members of Congress to keep their hands off Medicaid funding for children.

These are my reflections for today.


Click here to send an email to your Representative.

Call your representative directly, or call the Capitol Switchboard at 202-224-3121.


Author: Meg White

I am a lifelong educator and I hope to use this blog to reflect on what's happening in public education. These are my musings, opinions, and reflections. If you learn from them, good for us. Ignorance is no excuse. I have co-authored a book, "Questioning Assumptions and Challenging Perceptions: Becoming an Effective Teacher in Urban Environments" (available on amazon)

One thought on “Medicaid and special education services”

  1. This is an excellent explanation. I really fear for the children, especially those with disabilities. Living in a rural state where education budgets are already gutted, it makes it even worse.


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