Summary of "The Hidden Lifeline: How Medicaid Supports Our Schools"
Podcast: School Business Insider
Host: John Brucato
Release Date: April 8, 2025

In this compelling episode of ASBO International's School Business Insider, host John Brucato engages in a vital conversation with Jesse Mandel, the National Program Director for the Healthy Schools Campaign. They delve into the essential yet often overlooked role Medicaid plays in supporting school districts across the United States, especially in the face of potential federal budget cuts.

1. Introduction to the Episode

John Brucato opens the discussion by introducing Jesse Mandel and setting the stage for a deep dive into how Medicaid funding underpins various health services within schools. He emphasizes the collaboration between ASBO International and other organizations to assess the impact of possible Medicaid restructuring.

2. Understanding Medicaid: A 101

Jesse Mandel provides a foundational overview of Medicaid, elucidating its history and its significant presence in the American healthcare landscape. She explains:

"Medicaid is a health insurance program that serves one in five people in the United States, covering almost 40% of children through Medicaid and CHIP combined."
[02:43]

Mandel highlights the cooperative nature of Medicaid as a state and federal partnership, allowing states flexibility in structuring the program to meet their unique needs.

3. The Critical Role of Medicaid in Schools

Exploring Medicaid's integration into the educational system, Mandel outlines its pivotal role in funding:

• Health Professionals: Funding salaries for school nurses, psychologists, and specialized instructional support personnel.
• Mental and Behavioral Health Services: Supporting comprehensive mental health programs within schools.
• Assistive Technology and Equipment: Providing necessary tools for students with disabilities.

She notes the historical context:

"For over 30 years, Medicaid has supported the delivery of health services to students with disabilities by paying for their physical, mental, and behavioral health services."
[05:24]

The bipartisan Safer Communities Act of 2014 further cemented Medicaid's role in expanding mental health services in schools.

4. Survey Findings: How Schools Use Medicaid

In partnership with organizations like ASBO, NAME, and CASE, Healthy Schools Campaign conducted a nationwide survey to assess Medicaid's impact. Key findings include:

• 86% of Districts: Use Medicaid to fund salaries of health professionals and specialized staff.

  "86% of districts said that they use Medicaid to fund the salaries of health professionals and specialized instructional support personnel."
  [19:25]

• Over Half Use for Mental Health Services:

  "Over half of the respondents said they use Medicaid funds for mental and Behavioral Health Services."
  [19:25]

• 46% Allocate for Assistive Technology:

  "46% said they use Medicaid funding for assistive technology and specialized equipment."
  [19:25]

• 60% Reporting Increased Funding Over Five Years:

  "60% of the districts reported that Medicaid funding has increased over the last five years."
  [19:25]

Surprisingly, the survey garnered over 1,400 responses nationwide, with a higher participation from rural districts, underscoring Medicaid's outsized role in these areas.

5. The Threat of Budget Cuts

Mandel addresses the looming threat of federal budget cuts targeting Medicaid amid the budget reconciliation process. She explains:

"The budget reconciliation process is directed to cut $880 billion, impacting Medicaid severely because it's one of the largest expenditure areas."
[12:09]

These cuts are not unprecedented. In 2017, similar efforts to restructure Medicaid were met with strong opposition, preserving the program's integrity. However, the current fiscal pressures suggest significant reductions are likely inevitable.

6. Implications of Medicaid Cuts for School Districts

The potential reduction in Medicaid funding poses dire consequences for school districts:

• Staffing Cuts:

  "80% of districts said they would have to cut staffing, including layoffs or reductions of health professionals."
  [24:27]

• Reduction in Mental Health Services:

  "70% would have to cut mental and behavioral health services."
  [24:27]

• Decline in Student Resources:

  "62% would need to cut student resources, impacting overall student support."
  [24:27]

Moreover, 90% of districts anticipate that Medicaid cuts would necessitate reductions across their entire budget, not just within health services, leading to broader educational repercussions.

7. Disproportionate Impact on Vulnerable Students

Students with disabilities and those requiring mental and behavioral health support stand to be disproportionately affected:

• Jesse Mandel shares testimonials from affected districts:

  "Students that may have mental health needs that are not on an IEP will not be able to have their needs met."
  [28:41]

  "We would likely cut a program that is having the most significant positive impact on our students with the most challenging behaviors."
  [28:41]

This underscores the critical importance of Medicaid in ensuring equitable educational outcomes for all students, especially those with heightened needs.

8. Policy Recommendations and Advocacy

Mandel urges school business officials to stay informed and proactive:

• Stay Updated: Follow updates from ASBO, Healthy Schools Campaign, and related organizations.

  "Follow Healthy Schools Campaign and sign up for newsletters and action alerts."
  [32:12]

• Understand Local Impact: Assess how Medicaid currently operates within your district and the number of students enrolled. Utilize resources like the Georgetown Center for Children and Families' data.

• Advocate Actively: Engage with local representatives and policymakers to voice the critical role Medicaid plays in supporting students.

  "School business officials are such important messengers and can be champions for this program."
  [32:12]

9. Final Thoughts and Call to Action

In conclusion, Jesse Mandel emphasizes the urgency and importance of collective action:

"This is the moment to pay attention, to get involved... Less funds, less opportunities, less support. Cuts to Medicaid would have an impact across all services."
[34:40]

She calls on school business officials to amplify the message about Medicaid's indispensable role and to continue advocating for its preservation to sustain student health and educational success.

This episode serves as a crucial reminder of the interconnectedness between healthcare funding and educational outcomes. By highlighting the multifaceted support Medicaid provides to schools, Jesse Mandel and John Brucato underscore the immediate need for stakeholders to engage in advocacy efforts to protect this vital funding stream.