New Hampshire schools received $26.9 million in Medicaid reimbursements in 2016, but those payments could be in jeopardy with the proposed health care bill passed by the U.S. House of Representatives last week, according to the Concord Monitor.
The health care bill passed by the House–the American Health Care Act (ACHA)–would change the Medicaid program from a reimbursement program to a block
grant, where states would get a set amount of federal funding. And, the bill cuts the funding by $840 billion over 10 years:
That could deal a big blow to school districts, who rely on Medicaid to help defray the costs of certain medical services provided to students with disabilities. In 2016, Medicaid reimbursements to New Hampshire school districts totaled $29.3 million, according to Department of Health and Human Services records.
The AHCA doesn’t specifically target or cut funding for special education in schools. But advocates argue that with a smaller, finite pot of Medicaid money, states will be forced to ration dollars – and potentially cut eligibility for schools entirely.
While Medicaid doesn’t cover the entire cost of special education services, it is a significant source of funding. Here is a breakdown of how much each school district in New Hampshire received in 2016 through the Medicaid to Schools program, according to data from the Department of Health and Human Services. Federal funds provided by the Individuals with Disabilities Education Act (IDEA)–the primary federal funding stream for special education services–totaled approximately $50 million in 2015. That means that Medicaid accounts for over a third of federally-driven funds for students with disabilities in New Hampshire.
The Medicaid to Schools program covers only a fraction of the cost of services provided, said Concord Assistant Superintendent Donna Palley.
Special education costs are largely driven by state and federal mandates. Medicaid helps to pay for required services like special education evaluations, vision services, and speech, language, and hearing services–programs that students with disabilities rely on to thrive in the classroom.
But it doesn’t cover all of the costs–in Concord, Medicaid accounts for almost 10% of the the money necessary for programs, or about $1.15 million. Federal and state education aid covered another $2.5 million.
That means that any difference is made up by local taxes, and with fewer Medicaid dollars, taxpayers may be on the hook an even bigger share:
“Without that Medicaid reimbursement, somebody is going to have to pay for those services that are required by law. And the only ones that are left are the local taxpayers,” said Carl Ladd, director of the New Hampshire School Administrators Association.
Governor Chris Sununu hasn’t backed the bill yet, but supports moving forward with repealing the Affordable Care Act:
“This is one of several components of the AHCA that is of concern and we are working to thoroughly analyze its impact on New Hampshire. This item needs to be considered very carefully as the AHCA is moved forward and improved by the United States Senate,” Michael Todd, his spokesman, wrote in an email.