As members of Congress work through the budget reconciliation process, deep cuts to Medicaid, among other programs, continue to loom. Reductions in Medicaid would be devastating to Arkansas where almost half (47.1%) of our children are insured through Medicaid, higher than the national average of approximately 40%. It’s also important to remember that Medicaid plays a critical role in funding school-based healthcare, which benefits children, schools, and their broader communities.  

Studies indicate that increased access to school health providers improves health and academic outcomes, particularly for students with chronic health issues. In addition to school health staff and other personnel who help meet students’ health needs, some schools also have School-Based Health Centers (SBHCs). These are healthcare facilities located in or next to a school and provide students access to high-quality and convenient health care in their school environment. SBHCs do not replace school nurses since they provide services beyond the scope of the school nurse practice. Currently, there are 60 SBHCs operating in our state. 

Regardless of how school-based health is provided in a particular school, it is a critical support to meet students’ physical, mental, and developmental needs. Currently in Arkansas, schools can bill Medicaid for the following allowable health expenses:  

• occupational, physical, and speech therapy services;  

• the vision and hearing portion of Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT);  

• audiology services;  

• school-based mental health services; and  

• personal care if it’s medically necessary and included in the student’s Individual Education Plan (IEP) as a related service.  

Depending on the type of service billed, districts can spend the reimbursed funds either toward the district’s special education program or toward any health-related expense to benefit the general student population. In addition to direct services, administrative costs are also reimbursable. As a result, Medicaid is a significant source of revenue for schools. Arkansas school districts received over $75 million in total Medicaid reimbursement during the 2023-2024 school year. 

Earlier this year, Healthy Schools Campaign and its partners surveyed schools across the nation to learn how significant reductions in federal financing would affect school health services, student resources, and district funding. Findings include: 

• 90% of respondents agreed Medicaid cuts would result in district budget reductions in non-health related areas 

• 80% of respondents expect reductions and layoffs of school health staff and personnel 

• 70% expect reductions in mental and behavioral health services 

Medicaid cuts would also impact students with disabilities given the critical role Medicaid plays in supporting special education services. In response to the Healthy Schools Campaign survey, a special education teacher from rural Arkansas stated the cuts would “deeply affect the level of care and success the students receive in the classroom.” Another special education teacher from an urban area in Arkansas described the impact on students with speech disabilities, stating, “Without Medicaid, they would be hindered in adult life and less likely to have a good job. Many of these students wouldn’t receive these services if they couldn’t get them during school because their parents work and can’t take them during the day to therapy.”  

The impact of Medicaid cuts on students and school districts is clear. It will lead to job losses and reductions in vital services for students, especially those with chronic health issues and disabilities. It would lead to school district budget gaps. It would ultimately reduce protections for our country’s most vulnerable students. Protecting Medicaid protects students, schools, and communities.