Status of Health Care Reform
On June 22, 2017 the US Senate released its proposed Health Care Reform Bill.
It is important to note that this bill is very similar to the Health Care Reform Bill that was recently passed in the US House of Representatives. The Save Medicaid in Schools Coalition is very concerned that these bills will have a significant negative effective on children’s health care services for a number of reasons including the proposed changes in Medicaid financing.
The Save Medicaid In Schools Coalition has sent a letter to the US House and Senate leadership expressing their concerns in regards to the proposed bills. This letter can be found on the AASA, The Schools Superintendents Association website at:
Today (June 22, 2017) the Save Medicaid in Schools Coalition released the following on the Senate Health Care Reform Bill:
Also of interest is a link to the Larry Jacobs, Education Talk Radio interview on “The Relationship Of Schools and Medicaid”. Participating in the call were John Hill, NAME Executive Director and Kathy Merry, NAME Region 2 LEA Representative.
Medicaid is a vital source of health coverage nationwide, but the program’s role is even more pronounced in small towns and rural areas. Medicaid covers a larger share of nonelderly adults and children in rural and small-town areas than in metropolitan areas; this trend is strongest among children.
Click here to continue reading the Georgetown University paper.
Medicaid Helps Schools Help Children: Medicaid’s role in schools goes beyond ensuring that students with disabilities have access to the medical services they need to succeed. Read more details in this April 2017 article from the Center on Budget and Policy Priorities.
NAME is sharing this American Association of School Administrators report regarding proposed Medicaid cuts. To read more and to access the report entitled: Cutting Medicaid: A Prescription to Hurt the Neediest Kids, click here.
Additionally, click here to view AASA’s infographic on “8 Facts about Kids on Medicaid and the Services They Receive in Schools.”
Based on proposed actions by the new administration and the 115th United States Congress, there will likely be changes to the Medicaid program that will potentially impact schools. As the only national organization specifically focused on Medicaid in schools, NAME is monitoring the situation closely. With the support of NAME’s Board of Directors, I have agreed to co-chair the 2017 Save Medicaid in Schools Coalition (SMISC). Sasha Pudelski, Legislative Specialist, American Association of School Administrators and Kelly Vaillancourt Strobach, Director of Government Relations, National Association of School Psychologists are the other two co-chairs and are providing much needed leadership for this initiative. To date, approximately sixty national organizations have signed on to participate in the Save Medicaid in Schools Coalition.
The SMISC held an organizational meeting in the Rayburn House Office Building in Washington, D.C., on January 12, 2017. In addition to the Coalition members, several staff from the House of Representatives participated. The majority of the discussion at this first gathering focused on actions of potential concern for students who are served with funds generated via public health insurance programs:
• Repeal of the Affordable Care Act
• Medicaid Reform:
-Establishment of Block Grants/Per Capita Grants
-Elimination of the requirement that states include an Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit
• Changes to the Children’s Health Insurance Program (CHIP)
How each of these potential changes may be implemented remains to be seen. I am certain there will be lots of back and forth on actions that appear to be promising for children served via Medicaid, as well as those actions that appear to be concerning. Currently on the promising side, the following article reports how a number of GOP Governors who did not participate in Medicaid expansion during the Obama administration are now requesting flexibility to expand their states’ Medicaid programs:
The Coalition’s aim is to remind all involved that approximately half of the participants on Medicaid are children. Together, Medicaid and CHIP cover forty percent of all children in the United States. Changes to these programs that negatively impact schools’ capacity to ensure students are healthy and ready to learn will ultimately compromise not only the well-being of our youngest and most vulnerable citizens, but also our country’s future prosperity.
If you have questions or information to share about what is happening at the local, state, or national level, please contact me. You will also find updates about the SMISC Coalition and other news about school-based Medicaid on the NAME webpage at http://www.MedicaidForEducation.org.
John Hill, Executive Director
National Alliance for Medicaid in Education
With approximately sixty national organizations on board, the 2017 Save Medicaid in Schools Coalition (SMISC) is focused on proposed changes to funding for Medicaid and the Children’s Health Insurance Program (CHIP) and how those could affect students and schools. Click <here> to read more from NAME Executive Director John Hill.
Click here to read the 1/5/2017 CMS guidance on State Medicaid agency managed care plan arrangements’ responsibility to ensure that Medicaid enrollees under 21 years old have access to the full scope of federally mandated EPSDT services. The memo notes that states may opt to “carve out” certain EPSDT services and reimburse them, separately from managed care arrangements, on a fee-for-service basis – which some states do with IEP-required services provided by schools.
This fact sheet from the Kaiser Family Foundation examines key questions around the potential changes President-elect Donald Trump and the next Congress may seek to make in Medicaid. It considers multiple forms a repeal of the ACA could assume and potential structural changes to Medicaid, including through a block grant or a per capita cap. It also reflects on the impact such a repeal could have on coverage, financing, delivery system and payment reform, and access to care, particularly for complex and vulnerable populations. The fact sheet also discusses how executive powers can be used to make changes to Medicaid without congressional action, including new regulations and Medicaid waivers.
Please find link to fact sheet here.
Click this link to read an article by The Center on Budget and Policy Priorities about the anticipated impact of Per Capita or Block Grant funding on State Medicaid Programs: http://www.cbpp.org/research/health/per-capita-caps-or-block-grants-would-lead-to-large-and-growing-cuts-in-state
The National Health Law Program reviewed each State Medicaid Plan and created an issue brief on “Free-Care.” To view the brief and related information online, click here