Child in wheelchair and therapistA little-publicized effect of the health care legislation the House of Representatives recently passed is its potential impact on vital health services that special education students receive. 

The federal Individuals with Disabilities Education Act (IDEA) guarantees all children a free and appropriate education in the least restrictive environment. The Act requires that children with special needs receive individualized educational plans that include therapies and other services both in-school and after school. Many school districts rely on Medicaid to pay for the after-school services and therapies, such as speech, occupational and behavioral therapy, which are considered an integral part of a child’s overall educational plan. 

Under the health care bill passed by the House, the American Health Care Act (AHCA), the federal government would sharply limit its contribution to Medicaid, giving states a fixed amount per Medicaid beneficiary each year, indexed to inflation.

These federal Medicaid cuts, projected to be $880 million over 10 years, would place special education services and therapies in jeopardy.  If states have to pay a larger share of the Medicaid cost, coverage reductions or limits on services are likely.  As the New York Times reports in a recent article, advocates warn that “schools would have to compete for funding with other entities, like hospitals and clinics, that serve Medicaid-eligible children.”

The Save Medicaid in Schools Coalition, a group of school educators and advocacy organizations, has sent a letter to lawmakers arguing that requiring states to fund a larger percentage of health care costs will result in “higher taxes, eligibility cuts or curtailed services for children.”

“School-based Medicaid programs serve as a lifeline to children who can’t access critical health care and health services outside of their school,” the advocates wrote.

The National Disability Rights Network said in a May 4 press release: “[T]oday, we took a giant step backward. . . The projected loss of $880 billion in federal Medicaid dollars will compel states to ration health care for children, including important mental health services, impacting the ability of schools to provide needed education services to their students and lead to noncompliance with the federal mandates under the Individuals with Disabilities Education Act.”

Members of The Academy of Special Needs Planners in a recent webinar explained that the proposed cuts in federal Medicaid funds to the states could result in the reduction or loss of services and therapies for special needs students.

The American Health Care Act now moves to the Senate for debate and possible changes.