Why Medicaid Matters for Children and Schools
By Kiersten Stewart & Lena O’Rourke, FUTURES
March 12, 2025
Futures Without Violence and Healthy Schools Campaign have a long-standing shared commitment to ensuring children and adolescents can access services and supports they need to be safe, healthy and ready to learn.
Today, about 2 in 10 children have a physical or mental health issue that can affect their ability to succeed in the classroom. And more than 8 out of 10 low-income children with special healthcare needs don’t receive the care they need in traditional healthcare settings.
That’s why school-based health and mental health services matter. And Medicaid is a critical step towards making these services possible.
Schools are uniquely positioned to deliver health and mental health services in a safe and convenient location. School-based healthcare has been shown to improve academic outcomes for children and youth, especially in early grades, and provide a strong protective factor against violence. Schools also provide support networks and protection from violence, abuse, and exploitation.
To deliver health and behavioral health services in schools, school districts rely on Medicaid to pay for services delivered to Medicaid-enrolled students. Over the past decade, more and more school districts and states have utilized the full power of school Medicaid to support student health and well- being, bringing millions of dollars in new federal resources to states.
Medicaid funding can also help children exposed to violence heal from trauma.
The Centers for Medicare and Medicaid Services (CMS), the federal agency that administers the program, has issued guidance that allows Medicaid to cover services for children, who’ve experienced trauma, including in schools.
But this is all at risk as Congress prepares to debate its budget legislation. Policymakers have advanced a number of proposals that target cuts to federal financing for Medicaid. While the House and Senate have yet to reach an agreement, their draft budgets would both cut trillions over ten years, with a specific focus on Congressional committees with responsibility for Medicaid.
Cuts to federal Medicaid funding would dramatically and negatively impact state Medicaid programs and, in turn, school Medicaid’s ability to serve students.
Today, Healthy Schools Campaign released the results of a survey of more than 1,400 school district leaders from all 50 states and the District of Columbia that examines the impact on school budgets and students if there are federal Medicaid cuts.
The take away is clear: Medicaid cuts would lead to a significant reduction in school health professionals and mental and behavioral health services. The impact of the cuts will be felt across the country and in both rural and urban schools.
But data alone cannot tell the full story. School district leaders responded passionately in their longform answers about the impact of school Medicaid cuts specifically on their ability to provide mental health care to students:
- Medicaid cuts could have a significant impact on students with mental and behavioral health needs in [our school district], as many essential services rely on Medicaid funding.…In severe cases, a lack of early intervention could increase the likelihood of students entering the juvenile justice system, creating long-term negative consequences… Many families in rural areas like [our school district] already struggle to find mental health professionals who accept Medicaid, and reductions in funding could lead to even fewer available options.
- Medicaid cuts can have a significant impact on students with disabilities, as Medicaid often provides crucial funding for services such as therapy, medical equipment, and transportation. These services are essential for many students with disabilities to be able to access education.
- This money helps pay for universal mental health supports. It will remove adults who are solid objects for students who have experienced (ing) trauma. It will also mean there are less staff to support targeted and intensive behavior support plans.
- If the government cuts Medicaid funding for schools, the impact on student mental health services would be severe.…Without this funding, schools may be forced to reduce or eliminate these services, leading to longer wait times, fewer counseling sessions, and limited crisis intervention resources. This could result in increased behavioral issues, higher rates of absenteeism, and decreased academic performance…Additionally, the loss of Medicaid funding would put more strain on teachers and administrators, who are not equipped to address complex mental health needs
- Students will not be able to receive mental health services, care coordination, referrals to other services, and screenings that the students, school and district desperately need to help children work through mental health and trauma needs.
- Medicaid supports early diagnosis and treatment for mental health issues, which can prevent more severe problems later. Reductions could delay or eliminate these interventions, worsening long-term outcomes.
These passionate answers make clear that school officials, students and their communities would struggle in the wake of Medicaid cuts. Medicaid plays a critical role in funding school-based healthcare, supporting more than $7.5 billion in school health services every year.
To learn more, read the full report from the Health Schools Campaign on How Medicaid Cuts Will Harm Students and Schools.
