As we near the end of August, children across the country are returning to school. Some children will show up nervous, some will show up excited and others will show up disappointed that summer is over. But, to us, the most important question is, will they show up insured?
As of a few years ago, the trend was moving in the right direction. As highlighted by a recent analysis in Health Affairs, eligible children’s participation in Medicaid or the Children's Health Insurance Program (CHIP) grew to 93.7 percent between 2013-2016, a five point percentage increase. The authors credit investments in outreach, education and enrollment made possible through the Affordable Care Act (ACA).
But as these investments are rescinded and the Centers for Medicare and Medicaid (CMS) approves changes to Medicaid that deter enrollment, the progress to date is at risk. This makes it essential that parents, schools, districts and advocates work actively to make Medicaid enrollment part of their back to school plans. Research shows that children who are insured not only have better health care access, but also have better academic outcomes.
The first month of school is a time when parents are highly engaged with school. Back to School picnics, health fairs, registration packets, free wellness screenings — all of these touchpoints can create small spaces to check in on a families’ insurance status, connect families to enrollment assisters and specialists and, ultimately, get our school-aged children covered.
It’s easy to understand how Medicaid enrollment helps kids and their families access health care. But let’s talk more generally about how Medicaid enrollment helps promote school-based health services, one of the most efficient ways to get kids the physical, mental, behavioral, vision and dental care they need.
The key is Medicaid school-based claiming. If you dig into how schools get reimbursed for the Medicaid-eligible services they provide, it turns out that many of the formulas rely on the school’s total Medicaid enrolled student population, not their Medicaid eligible student population. Schools with high rates of Medicaid enrollment for their eligible students will be able to maximize the amount of reimbursement they receive, making their school based health services more sustainable.
Getting Care and Coverage
The breadth of school-based health services that can be reimbursed by Medicaid has expanded greatly in the last few years as the result of a Medicaid guidance change known as the free care policy reversal. Because this opportunity is still new, states, school districts and schools are just beginning to capitalize on it. These resources are a good starting point for understanding how to leverage Medicaid to fund school health services:
- Advocates' Guide To The Change In The Medicaid Free Care Rule, Community Catalyst
- Stakeholder’s Guide to Implementing the Change in the Free Care Policy, Healthy Schools Campaign
Interested in taking action on getting more kids in your district enrolled in Medicaid? You may want to start by arming yourself with some key data. Find out how many Medicaid-eligible students are enrolled in your district, what the enrollment rate is and whether your district is currently getting Medicaid revenue for providing school based health services. These resource guides can also help:
- A Lesson Plan to Enroll Children in Medicaid and CHIP This Back-to-School Season, Insure Kids Now Resources
- Guide to School-Based Outreach for Health Coverage Enrollment, Center on Budget Policy Priorities Back to School School-based Outreach Guide (2016)
- Medicaid and CHIP Provide Health Coverage for Many School-Age Children, Yet Gaps Remain Georgetown Center for Children and Families report on district level Medicaid data
We urge you to help us make sure the trends in Medicaid and CHIP coverage are not reversed by finding out what your state and school district are doing to make sure kids are in school, insured and ready to learn.
Alexandra Mays, Senior National Program Director, Healthy Schools Campaign contributed to this blog as a guest blogger.