‘Repeal and Replace’ Cuts Schools’ Medicaid Funding

The numbers aren’t in, so we don’t know how much the Senate “repeal and replace” healthcare bill plans to cut from Medicaid, but the bill passed by the House takes an $880 billion bite out of the program over ten years, and indications are the Senate bill bites down even harder. Both bills cut health care for our most vulnerable citizens while giving the richest Americans huge tax cuts. (For the first million you make, you get a tax cut the size of the median U.S. income.) Most Democrats are alarmed, and some Republicans, especially governors in states that went with the Medicaid program, like Arizona, are concerned as well. If Ducey is urging caution, you know there’s something to worry about.

Schools would be affected by the cuts. Medicaid is used to cover some special education costs to schools which are above and beyond funds states supply to take care of those students’ needs. It also covers some of the costs of vision and hearing screening for children, along with part of the salaries for nurses, psychologists and other health care professionals. If Medicaid funding is cut and schools have to compete for limited funds with services for children provided outside of school in hospitals, clinics and doctors’ offices, children will inevitably lose vital services at the expense of their health and their educations.

Here is how it’s explained on the Arizona Department of Education website.

Medicaid School-Based Claiming (MSBC) is a joint federal and state program that offers reimbursement for both the provision of covered medically necessary school-based services and for the costs of administrative activities, such as outreach activities to identify eligible students and enroll them in the program, that support the Medicaid school-based program. . . .

Many children receive covered Medicaid services through their schools. Medicaid will reimburse schools for documented medically necessary services that are provided to children who are both Medicaid eligible and who have been identified as eligible under the Individuals with Disabilities Education Act (IDEA), 34 CFR §300.306. Currently, schools can receive reimbursement for physical therapy, occupational therapy, speech therapy, nursing services, health aides, certain transportation, and behavioral health services. . . .

Schools are often involved in informing families of their potential eligibility for Medicaid or in helping them arrange medical appointments for children. These activities are considered Medicaid outreach and are administrative costs.

There’s no money in  the state budget to pick up the tab for services the Republican bill will cut. Children will go without health care, but lots of millionaires and billionaires will get healthy tax cuts amounting to tens of thousands, hundreds of thousands, millions of dollars. Somehow in the conservative mindset, that’s a good trade-off.

This article appears in Jun 22-28, 2017.