California education officials are sounding the alarm over Congressional Republicans' proposed health care overhaul bills, saying changes to Medicaid could leave the state or school districts scrambling to pay for critical special education services they don't have the option of cutting.
The health care bill the U.S. House passed in May would place a cap on Medicaid payments to states, a move that could trim states' Medicaid funding by 25 to 35 percent.
Funding from Medicaid, referred to in California as Medi-Cal, helps school districts cover the costs of serving special education students who are entitled to receive critical healthcare services in school — such as a child who needs a ventilator or a feeding tube.
If a child's "individual education plan" — the negotiated document spelling out supports a student with disabilities needs in order to receive a "free and appropriate" public education — calls for these services, California Department of Education spokesman Robert Oakes said districts are required to provide them at school, with or without Medi-Cal.
"If Medi-Cal funding drops because there’s a cap," Oaskes said, "the school districts are going to have to pay for it. We don’t know where that kind of funding is going to come from."
The current U.S. Senate health care bill also contains cuts to Medicaid. But Majority Leader Mitch McConnell (R-Kentucky) delayed a vote on the legislation before the July 4 recess — in part because members of his own caucus raised concerns about the Medicaid provisions.
Schools across the U.S. receive roughly $4 billion in Medicaid reimbursements, according to a national organization representing school superintendents, and nearly two-thirds of U.S. school districts use this funding to pay for not only health care workers to work with these students, but for speech-language pathologists, school psychologists and school social workers as well.
Medicaid funding also pays for vision and hearing screenings, health aides and other services at school sites for students from Medi-Cal eligible families, Oakes said.
District-by-district figures of how many students receive Medicaid-funded services were not readily available. But Oakes said populations of Medi-Cal-eligible students are highest in rural schools and in urban districts with large low-income populations; in the Los Angeles Unified School District, he said, 55 percent of students are eligible for Medi-Cal.
The Association of California School Administrators and California School Boards Association recently sent a joint letter to the state's Congressional delegation describing what would be at stake if cuts to Medicaid were realized.
"Absent this essential federal support for our most vulnerable populations," the letter said, "schools will not only struggle to provide high quality services to students with disabilities, but will also have great difficulty in meeting the federal mandates associated with Individuals with Disabilities Education Act."