Medicaid Cut Puts Schools in a Jam, Children With Disabilities and Others Disadvantaged at Risk

June 6, 2017

Our Secretary of Education seems still confused (charitable word) about our equal opportunity in education laws.

She was asked again in a Congressional hearing whether her department would deny federal funds to private schools with students who have vouchers her budget would pay for if they discriminated. And she said again she thinks that’s a choice for states to make.

But the Individuals With Disabilities Education Act is one of three major federal laws prohibiting discrimination in federally-funded education programs. And it’s by far and away the most specific.

Schools must assess children with disabilities and develop plans for each that will meet their unique needs, enable them to learn as much as they possible can of what’s expected of their classmates and in the “least restrictive environment,” i.e., by including them in regular classrooms and other such settings, except in special child-specific circumstances, rather than routinely segregating them.

States get federal grants to help defray their school districts’ costs. But that’s not the only source of funds they use. They tap Medicaid to reimburse them for the costs of screening and providing appropriate health services to their low-income disabled students.

They may also use Medicaid funds for the early and periodic screening, diagnostic and treatment services that the law entitles all enrolled children to. Their parents may not even know their children can get them until the school informs them and perhaps helps them apply.

Needless to say, I hope, the House Republicans and Trump administration plans to convert Medicaid to a block grant or set a per beneficiary reimbursement limit have school officials very worried.

A recent member survey conducted by the American Association of School Administrators tells us why, both in summary form and numerous personal responses.

Once the federal government shifts costs to states by whichever means, they foresee a losing competition with other institutions that rely on Medicaid funds, e.g., hospitals, doctors, other providers like the Federally Qualified Health Centers I wrote about.

States will have the flexibility to choose who’s eligible for their programs, what services they can receive and, as we now learn, time limits perhaps, work requirements, premiums they’ll have to pay or get kicked out of the program.

States may, AASA says, decide that school districts can’t get any Medicaid funds at all. But schools will still have to comply with the IDEA requirements. Where will that money come from?

A top line answer is that schools would lay off health professional staff and others with expertise in educating children with disabilities. Alternatively — or perhaps in addition to — schools would cut back on services for all students in so far as they legally can.

AASA and some members quoted cite mental health services in particular. About one in five children show symptoms indicating needs each year.

Neglect them and children suffer not only anxiety, depression and other effects due to trauma or toxic stress. Their academic performance suffers, setting them on the path to drop out when they’re teens.

Their abilities to control their emotional impulses, plan and manage their activities productively and relate well to others suffer too.

These so-called social and emotional competencies obviously give those that have them advantages in both their personal lives while young and long thereafter — and advantages that make getting and keeping a job every so much more likely.

Seems like a lot I know to pack into a post on only one — and hardly the most consequential — impact of what Trump’s roughly estimated $1.3 trillion cut to Medicaid funding would do — or even the House Republicans’ $839 billion.

But the well-being and futures of school-age children ought to matter to all of us. And as I said, it’s not only children with disabilities those cuts would put at risk, but all their peers.

Most at risk are the other educationally disadvantaged students for whom Title VI of the Elementary and Secondary Education Act—now called the Every Child Succeeds Act—aims to make the equal educational opportunity guarantee in the Civil Rights Act a reality.

Trump’s budget would increase ESSA by $1 billion, but channel the extra only to districts that promote parental choice.

It would also siphon off money from high-poverty schools by shifting each student’s share to any publicly-funded school s/he transfers to. And we know that’s not going to be another high-poverty school.