This commentary is part of TCF’s Beyond Health series, which discusses the many potential harms of up to $880 billion in potential Medicaid cuts across issue areas.
The U.S. House of Representatives, with only Republican votes, passed a budget resolution on February 25, 2025 that demands up to $880 billion in ten-year savings from Medicaid. This would clearly and deeply harm health coverage, services, and state budgets. This amount is more than all federal Medicaid spending on children; Medicaid covers four in ten children in the United States. But that’s not where the impact ends.
Drastic Medicaid cuts like the ones being proposed would directly impact school-based health services for K–12 students, particularly those from low-income backgrounds, who rely on schools for access to essential physical and mental health services.
Medicaid Support for School-Based Health Services
Medicaid serves as both a source of health coverage for students and a source of payment for school-based health services. Under the House proposed spending reductions, millions of students stand to lose access to critical mental and physical health care—jeopardizing their health, academic performance, mental well-being, and long-term opportunities. Research has consistently linked inadequate coverage and care to lower academic achievement for students, resulting in higher absenteeism, poorer mental health, and widened educational disparities.
Medicaid has for many decades supported school-based health services. The program has since 1988 reimbursed states for certain medically necessary services provided in school for students with Individualized Education Programs (IEPs), delivering billions in federal funding to support health services in schools. And importantly, through an option available since 2014, nearly half of all states depend on Medicaid to offer a broader range of health services in schools for all students from disadvantaged communities. Many of these students already face significant barriers to health care, including cost, transportation, and availability of services. Medicaid allows schools to provide critical services such as health screenings, vaccinations, physical therapy, and mental health support inside of school buildings. For students with disabilities, Medicaid helps fund special education programs, ensuring they receive the medically necessary support needed to succeed academically and socially. Schools even rely on Medicaid services to hire and retain school-based medical professionals.
Without these health care supports, the consequences to children could be devastating. Following a once-in-a-lifetime pandemic and an ongoing youth mental health crisis, states turned to Medicaid to meet the urgent needs of their students. Under the Biden–Harris administration, the U.S. Department of Education partnered with the U.S. Department of Health and Human Services through guidance, resources, and technical assistance to increase the services offered and covered by Medicaid in schools. This partnership, supported by $50 million from the Bipartisan Safer Communities Act, led to twenty-five states increasing access to services supported by Medicaid—compared to just seven in 2020. This expansion has been transformative: more schools now receive reimbursement for providing health care. In other words, states can now ensure more students get the care they need without leaving their school campuses.
For example, Michigan’s adoption of Medicaid options and state investments led to a 93 percent increase in behavioral health providers in schools and a 52 percent increase in school nursing staff. As a result, more than 85,000 students annually receive health screenings, and nearly 30,000 receive direct services through their schools. It is worth noting that this expansion has reached students in rural and underserved areas, where more children are covered by Medicaid and fewer health care providers operate. By allowing schools to offer critical services like mental health counseling, speech therapy, and routine screenings, Medicaid ensures that students in these areas can access essential care without facing long travel distances or financial barriers—ultimately supporting both their health and academic success.
Impact of Deep Medicaid Cuts to School-Based Services
Four out of five recently surveyed school district staff noted that cuts to Medicaid would require them to cut staff providing vital school services. The consequences would ripple through classrooms and communities, worsening educational disparities, deepening health inequities, and limiting the future opportunities of an entire generation. If we truly care about protecting the well-being, academic success, and future potential of American children, we must protect Medicaid.
Tags: medicaid, early education, education programs, medicaid cuts, beyond health
Beyond Health: Potential Impact on K–12 Students of $880 Billion in Medicaid Cuts
This commentary is part of TCF’s Beyond Health series, which discusses the many potential harms of up to $880 billion in potential Medicaid cuts across issue areas.
The U.S. House of Representatives, with only Republican votes, passed a budget resolution on February 25, 2025 that demands up to $880 billion in ten-year savings from Medicaid. This would clearly and deeply harm health coverage, services, and state budgets. This amount is more than all federal Medicaid spending on children; Medicaid covers four in ten children in the United States. But that’s not where the impact ends.
Drastic Medicaid cuts like the ones being proposed would directly impact school-based health services for K–12 students, particularly those from low-income backgrounds, who rely on schools for access to essential physical and mental health services.
Medicaid Support for School-Based Health Services
Medicaid serves as both a source of health coverage for students and a source of payment for school-based health services. Under the House proposed spending reductions, millions of students stand to lose access to critical mental and physical health care—jeopardizing their health, academic performance, mental well-being, and long-term opportunities. Research has consistently linked inadequate coverage and care to lower academic achievement for students, resulting in higher absenteeism, poorer mental health, and widened educational disparities.
Beyond Health
Read more about what deep Medicaid cuts would mean for everyday Americans.Beyond Health: Medicaid Cuts Would Bring Widespread Harms to Americans
Beyond Health: Potential Impact on Foster Youth of $880 Billion in Medicaid Cuts
Beyond Health: What Cutting Medicaid Means for Disabled People, Including in Maine
Beyond Health: Medicaid Cuts Will Further Exacerbate the Epidemic of Gun Violence
Beyond Health: Potential Impact on K–12 Students of $880 Billion in Medicaid Cuts
Beyond Health: Medicaid Cuts Could Put College Dreams on Life Support
Beyond Health: Threats to Medicaid Funding Would Endanger Child Care Too
Medicaid has for many decades supported school-based health services. The program has since 1988 reimbursed states for certain medically necessary services provided in school for students with Individualized Education Programs (IEPs), delivering billions in federal funding to support health services in schools. And importantly, through an option available since 2014, nearly half of all states depend on Medicaid to offer a broader range of health services in schools for all students from disadvantaged communities. Many of these students already face significant barriers to health care, including cost, transportation, and availability of services. Medicaid allows schools to provide critical services such as health screenings, vaccinations, physical therapy, and mental health support inside of school buildings. For students with disabilities, Medicaid helps fund special education programs, ensuring they receive the medically necessary support needed to succeed academically and socially. Schools even rely on Medicaid services to hire and retain school-based medical professionals.
Without these health care supports, the consequences to children could be devastating. Following a once-in-a-lifetime pandemic and an ongoing youth mental health crisis, states turned to Medicaid to meet the urgent needs of their students. Under the Biden–Harris administration, the U.S. Department of Education partnered with the U.S. Department of Health and Human Services through guidance, resources, and technical assistance to increase the services offered and covered by Medicaid in schools. This partnership, supported by $50 million from the Bipartisan Safer Communities Act, led to twenty-five states increasing access to services supported by Medicaid—compared to just seven in 2020. This expansion has been transformative: more schools now receive reimbursement for providing health care. In other words, states can now ensure more students get the care they need without leaving their school campuses.
For example, Michigan’s adoption of Medicaid options and state investments led to a 93 percent increase in behavioral health providers in schools and a 52 percent increase in school nursing staff. As a result, more than 85,000 students annually receive health screenings, and nearly 30,000 receive direct services through their schools. It is worth noting that this expansion has reached students in rural and underserved areas, where more children are covered by Medicaid and fewer health care providers operate. By allowing schools to offer critical services like mental health counseling, speech therapy, and routine screenings, Medicaid ensures that students in these areas can access essential care without facing long travel distances or financial barriers—ultimately supporting both their health and academic success.
Impact of Deep Medicaid Cuts to School-Based Services
Four out of five recently surveyed school district staff noted that cuts to Medicaid would require them to cut staff providing vital school services. The consequences would ripple through classrooms and communities, worsening educational disparities, deepening health inequities, and limiting the future opportunities of an entire generation. If we truly care about protecting the well-being, academic success, and future potential of American children, we must protect Medicaid.
Tags: medicaid, early education, education programs, medicaid cuts, beyond health