There are plenty of reasons some legislators, not to mention many Americans, are concerned about the health care bill that narrowly passed in the U.S. House of Representatives in May. But schools are particularly focused on two groups most likely to suffer if the bill becomes law: students with disabilities and those living in poverty.
In its attempt to repeal and replace the Affordable Care Act, House supporters of the proposed health care bill included a plan to cut Medicaid by 25 percent, or $880 billion, over the next decade. School districts nationwide depend on Medicaid to cover the costs of special education teachers, services and equipment, as well as preventative care.
The U.S. Senate has yet to introduce its own version of a health care bill, but many legislators in both houses have made cutting Medicaid spending a top goal. For educators, families and students, the message is clear: Educating the country’s most vulnerable students is no longer a federal priority.
Less than 1 percent, or about $4 billion, of Medicaid spending is directed to public schools, but it makes up one-third of the U.S. Department of Education’s special education budget appropriation. According to a survey conducted in January by the American Association of School Administrators (AASA), two-thirds of districts indicated that they use Medicaid dollars to cover salaries for staff professionals and support personnel, such as speech-language pathologists and school social workers.
For educators, families and students, the message is clear: Educating the country’s most vulnerable students is no longer a federal priority.
A coalition that includes the AASA wrote a letter to top lawmakers, describing Medicaid as a cost-effective and efficient provider of services that are essential to ensuring all children are able to learn and be successful academically.
“School based Medicaid programs serve as a lifeline to children who can’t access critical health care and health services outside of their school,” the coalition wrote.
The group is particularly concerned that under the bill, the bulk of health care costs would be transferred to states, which would be compelled to “ration health care for children.” Block grants or per-capita limits would pit school systems against hospitals and other health care providers for limited Medicaid dollars, and schools would inevitably lose.
Since 1975, when Congress passed the Individuals with Disabilities Education Act (IDEA), schools have been required to provide “free and appropriate public school education” to students with disabilities. Congress has never fully funded its promised 40 percent of the cost required by this mandate—federal funding this year is just 16 percent—which is why Medicaid has proved so essential.
Congress has never fully funded its promised 40 percent of the cost required by this mandate—federal funding this year is just 16 percent—which is why Medicaid has proved so essential.
If the House health care bill were enacted as is, school systems would find themselves in a double bind: They are federally mandated to provide special education services, and yet the federal government is drastically reducing the funds necessary to fulfill the mandate.
This bill falls on the heels of the U.S. Supreme Court’s unanimous decision in March that public schools must give students with disabilities the opportunity to make “appropriately ambitious” advancements in their education. According to the coalition, drastic cuts to Medicaid would result in just the opposite: school systems that fail to comply with IDEA requirements due to staff cuts and lack of necessary supplies. Or loss of funding could result in cuts to general education, as school districts divert funds from “non-mandated” parts of general education to cover the IDEA mandates.
To be certain, severe Medicaid cuts would widen the disparity between higher- versus lower-income districts and increase educational inequity. Some wealthier localities might decide to increase taxes to ensure the quality of their school district remains the same. Families of special needs students who can afford it might opt for a private education.
Students in rural and urban districts, who are least likely to have access to physical and mental health services anywhere other than school, could lose that vital care. The coalition estimates that seven out of 10 students who receive mental health services access them at school. Students living in poverty could also miss out on preventative care, such as hearing and vision screenings.
This should be cause for alarm. As the coalition noted, “A school’s primary responsibility is to provide students with a high-quality education. However, children cannot learn to their fullest potential with unmet health needs.”
This blog was produced in partnership with the anti-hate news project 500 Pens.
Applegate is a journalist, editor and storyteller who focuses on youth, family and social justice issues.
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