Maximizing Medicaid Funding for School-Based Services: A Path to Student Well-Being


If you are an education advocate in your state, take the steps below to expand Medicaid for school based services. Your actions today will make a significant impact on student well-being and academic achievement.


In the complex landscape of educational funding, one often overlooked but vital resource is Medicaid. While traditionally associated with healthcare for individuals in certain income groups, Medicaid also has the potential to play a crucial role in funding health services in schools. There’s a significant opportunity for states to maximize this funding to benefit all Medicaid-enrolled students and states need to be taking advantage of it. 

Understanding Medicaid Funding for School-Based Services

The federal government allocates billions of dollars annually to schools through Medicaid, aimed at enhancing access to quality physical, mental, and behavioral health services for eligible students. These funds cover a spectrum of services, from routine health screenings to therapies such as physical, speech, and occupational therapies. While most states have Medicaid plans in place for students with disabilities under the Individuals with Disabilities Education Act (IDEA), only a fraction have extended reimbursement to all Medicaid-eligible students beyond those served under IDEA.

Steps to Expand Medicaid School-Based Services

States have the power to broaden Medicaid reimbursement for school-based services to all eligible students. Here’s how:

  1. Review State Plan: State Educational Agencies and Medicaid Agencies can collaborate to review the State Plan approved by the Centers for Medicare & Medicaid Services (CMS) regarding school-based services. This includes identifying necessary changes to expand reimbursement for all Medicaid-eligible students.
  2. File a State Plan Amendment (SPA): Medicaid Agencies can file an SPA with CMS, documenting decisions regarding reimbursable school-based services and provider requirements.
  3. Leverage Technical Assistance: Utilize resources like the Medicaid and School Based Services Technical Assistance Center to ensure efficient service delivery and reimbursement. Collaborate with local educational agencies and learn from other states’ best practices.

Benefits of Maximizing Medicaid Funding

Expanding Medicaid-funded services in schools benefits students, families, and educational institutions in numerous ways:

– Increased Access: By offering health services in schools to all Medicaid-enrolled students, access to crucial care significantly improves, particularly for mental health services, where students are six times more likely to seek help when available on campus.

– Financial Relief: Medicaid contributes billions annually to school districts, easing financial burdens and providing sustainable resources for essential services. For instance, Chicago Public Schools alone receives millions in Medicaid reimbursement annually.

– Federal Revenue Boost: States that expand Medicaid-funded school services can expect substantial increases in federal funds. Pilot projects in states like Colorado, Georgia, and Michigan demonstrate the potential for millions in additional federal revenue by including various health professionals in reimbursement plans.

Currently, only 16 states are fully leveraging Medicaid funding for school-based services. By expanding reimbursement to all Medicaid-enrolled students, states can unlock crucial resources to support student well-being and academic success.