Key Takeaways
- Nearly 80 million Americans—including 38 million children and 1 in 10 education support professionals—receive health care coverage through Medicaid and the Children’s Health Insurance Program.
- Under a proposal currently moving through Congress, 13.7 million Americans could lose their health coverage.
- Educators are speaking out about the importance of Medicaid funding to our families, schools, and communities.
Iowa Spanish teacher Nancy Baker Curtis’s nine-and-a-half-year-old son Charlie loves monster trucks, playing with his friends, and bike-riding with his mom. Earlier this year, he was running down the sidewalk, fell, and had to get stitches in his chin.
“It’s terrible, of course, but it’s also amazing because at the age of two, he couldn’t crawl or even sit up,” says Baker Curtis.
Six days after his birth, Charlie was diagnosed with a serious infection and was admitted into the hospital, where he would remain for 30 days. He was in and out of the hospital several more times before he turned nine months old.
Baker Curtis saw that he wasn’t hitting developmental milestones and called in early intervention services that got Charlie started with physical therapy, speech therapy, feeding therapy, and more.
“The reason Charlie can run and swallow and use his talker is because Medicaid has covered life-changing therapies for our son,” she says.
But now Congress is threatening to make such deep cuts to Medicaid that students with disabilities—kids like Charlie—will lose therapies and services they count on to thrive and even survive. Millions more adults and children will lose their only source of healthcare.
As part of the federal budget process, the U.S. House of Representatives is seeking changes to Medicaid that will make fewer people eligible for the program.
According to an analysis by the nonpartisan Congressional Budget Office, under the House plan, 8.6 million people would lose coverage under Medicaid, and 5.1 million would lose coverage under the Affordable Care Act—a total of 13.7 million Americans.
Charlie's school-based Medicaid services include a health associate or nurse to consult on his IEP and Health plan. Because Charlie started experiencing seizures, Medicaid covered seizure training for his entire team. He also receives speech, occupational, and physical therapy at school.
Baker Curtis and her husband—who also have a 12-year-old daughter to care for—both have employer-provided health insurance. But their policy doesn’t cover anywhere near the amount of services that Charlie needs.
“Under our PPO, we qualify for a combined 30 appointments for occupational and physical therapy,” says Baker Curtis. “We would blow through those appointments in about three and a half months, or less. What would we do for the rest of the year?”
Medicaid Services in Schools
Because Charlie qualifies for Medicaid, his school district can bill the program to ensure that he has the services he needs during the school day. This includes specialized transportation and his one-on-one aide.
Millions more children who do not have significant disabilities qualify for Medicaid because they are from low-income families. Schools can bill Medicaid for services that support these students, too—everything from mental health counseling to medical, dental, and vision screenings—and those services can benefit every student in the school.
In all, nearly 80 million Americans—including 38 million children and 1 in 10 education support professionals—receive health care coverage through Medicaid and the Children’s Health Insurance Program.
Jimbo Lamb, a high school math teacher and president-elect of the Southern Region of the Pennsylvania State Education Association, says Medicaid is critical to the region he represents, which includes Harrisburg City and rural Fulton County.
“There are about 67,300 kids on Medicaid in this region, and when they enter our schools, we are able to get funding for the services they need there,” says Lamb.
Don’t Slash Medicaid and Children's Health Care
One-fifth of the U.S. population depends on the program, including more than half our students and many ESPs.
“Medicaid helps districts pay for screenings, evaluations, early interventions, and services for accelerated learners, too,” says Lamb. “We need to make sure that all kids are healthy and able to come to school so they can get the education they deserve.”
Research shows that covered children miss fewer school days, are more likely to attend college, and earn more as adults.
Medicaid is the fourth-largest source of funding for the public school system, supporting over $7.5 billion of school-based health services annually, according to the Healthy Schools Campaign.
As part of a recent study, the organization asked school district leaders from all 50 states and the District of Columbia how Medicaid cuts would affect school health services and staff:
- 80% of respondents expect reductions and layoffs of school health staff and personnel.
- 70% expect reductions in mental and behavioral health services.
- 62% expect a reduction in resources, including assistive equipment and technology for students with disabilities.
Such cuts would immediately impact students in public schools, and would put more vulnerable kids at risk.
Why Cut Medicaid?
With so much riding on Medicaid—funding that sustains many lives across the nation, including approximately 40 percent of all children under age 18—why are some federal lawmakers determined to make deep cuts?
The reality is that some House Republicans are looking for ways to fund two Trump administration priorities: a massive tax giveaway for the wealthy and a $100 billion private school voucher scheme.
Extending the tax cuts for the wealthy established during the first Trump administration—which caused taxes to rise for many middle-class families while households in the top 1 percent got an average $61,000 tax cut—would cost $4.3 trillion over the next decade.
Incredibly, some elected leaders would sacrifice the well-being of our students and communities to deliver more handouts to the most privileged among us.
“Here in Iowa, we already have families on waiting lists to receive some of the wraparound services like we have for Charlie,” says Nancy Baker Curtis. “They might have to wait six months or a year—but what if we cut Medicaid? Will they ever get what they need?”
In April, she went to a town hall event to ask Sen. Charles Grassley to commit to protecting Medicaid. “He has called himself a champion for children with disabilities, but I want to know what he’s going to do now, in 2025, for kids like Charlie,” says Baker Curtis.
The venue was full, and she was told to wait with the overflow crowd in the atrium and that Sen. Grassley would come down to see them. But he never came down.
“I wanted him to meet Charlie,” says Baker Curtis. “I will work with anyone across the aisle. I don’t want this to be a political issue when so many people’s lives are on the line.”
ASK THE EXPERT
We asked Cynthia Blankenship, NEA’s health policy and benefits expert, what else readers should know about Medicaid to become effective advocates for preserving this critical funding. She offered these key takeaways:
- The importance of Medicaid funding to state budgets cannot be overstated
“If Congress disenrolls people from Medicaid—and it doesn’t ultimately matter what path they take to accomplish that—it will blow a giant hole through states’ budgets,” says Blankenship. Forty states chose to expand Medicaid under the Affordable Care Act, and the federal match for services under the expansion is 90 percent. “Without those federal dollars, the state is then forced to either cut back on other priorities—usually education or transportation spending—or drop participants from the program,” Blankenship says. She went on to explain that nine states have “trigger laws” that dictate that if the federal match for the Medicaid expansion drops below 90 percent, they automatically disenroll those participants. Another three states have laws that would trigger an evaluation that requires a timeline for eventual disenrollment.
- Medicaid cuts have an outsized impact on rural communities
Rural areas will be hit especially hard, Blankenship says, because they have unique barriers. “There are travel issues, with greater distances to get to providers and less public transportation. There is also less employer-provided healthcare in rural areas, and more chronic disease,” she says. “Another thing that we know is that when Medicaid is cut, hospitals close. Rural areas have fewer medical facilities, so if they close, entire communities are put at greater risk.”
- We are all financially affected by Medicaid cuts.
“Sometimes people don’t advocate for Medicaid because they don’t realize that the programs they or their loved ones are enrolled in are actually Medicaid,” says Blankenship. States that chose to expand Medicaid under the Affordable Care Act typically gave that expansion program a different name—Virginia’s Cardinal Care and Connecticut’s Husky Health, for example, are both Medicaid programs. Even families who do not use any Medicaid services will still be affected by cuts to the program. “What we know from every non-partisan study is that employer-sponsored healthcare costs drastically increase because of Medicaid cuts,” Blankenship explains. “When large numbers of people are disenrolled from the program, providers have to increase fees, which is felt by the insurance companies and passed on to our members and other workers.”
Keeping Students and Educators Safe & Healthy
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