School-Based Outreach for Health Coverage: Which Policies Make It Successful?

By Liz Hagan

Our recent webinar (recording available here) focused on the importance of doing school-based outreach as one relatively easy way to get students and families enrolled in health coverage.  In recent years, school-based outreach has been one of the many successful strategies used to enroll kids in Medicaid and the Children’s Health Insurance Program (CHIP). Now, there’s a great opportunity to enroll not just kids, but their families too: Starting this year, millions of adults are newly eligible for Medicaid or low-cost coverage through the health insurance marketplaces.

How can schools maximize enrollment of students and their parents in health coverage? Here are three policy options schools can pursue:

  1. Do targeted outreach to students who receive free or reduced-price lunches through the National School Lunch Program
  2. Conduct Medicaid administrative claiming (MAC) in schools
  3. Enroll students with special needs in Medicaid

1. Do targeted outreach to students who receive free or reduced-price lunches through the National School Lunch Program

Eligibility for the school lunch program is based on students’ household income, and the eligibility levels for the school lunch program are similar to the eligibility levels for Medicaid, CHIP, and low-cost marketplace coverage. That means these students and their families are likely eligible for coverage, so reaching out to them will likely result in many new enrollments.

There are several ways schools can contact these students’ families to find out if they’re interested in learning more about health coverage:

  • Ask about the family’s health insurance status on school lunch program applications.
  • Include a check box on school lunch program applications where families can indicate that they want more information on coverage options.
  • Send health forms home with students every year and ask families to fill them out and send them back.

After schools have confirmed which parents or guardians are interested in getting more information, schools can provide these families with information on where to get application and enrollment assistance. Here are a few ways schools can do this:

  • Send pamphlets home (either by mail or with students) with information on the new coverage options.
  • Conduct auto-calls or send emails from the principal to students’ families that emphasize how important it is to have health coverage to keep kids healthy and that tell them how to get covered.
  • Have school staff call students’ homes to tell students and their families about the new coverage options and where to apply for coverage.
  • Host or co-host enrollment events in the school or elsewhere in the community and invite parents to attend.

In addition, federal law allows schools to share the information they get from the school lunch program with their state’s Medicaid agency (except for parents who have opted out of allowing the school to share this information). The Medicaid agency can then reach out to these families directly.

Remember that there may be confidentiality requirements that pertain to the options listed above, and your state may have specific requirements relating to data sharing.

2. Conduct Medicaid administrative claiming (MAC) in schools

Though each program varies by state, the MAC program is a federal program that allows schools to be paid for conducting Medicaid outreach to potentially eligible students. Through this program, schools can explore the best ways to encourage entire families to enroll in coverage.

Various school personnel can perform this outreach. It can range from direct enrollment by school nurses to administrative staff sending information home to parents and guardians. For example, in Texas, schools can receive MAC funding for these activities:

  • Helping families complete Medicaid applications.
  • Informing pregnant and parenting teens about Medicaid coverage for prenatal and well-baby care.
  • Distributing literature about Medicaid.

3. Enroll students with special needs in Medicaid

Under the Individuals with Disabilities Education Act (IDEA), schools are allowed to receive Medicaid reimbursement for providing certain services to Medicaid-eligible students with special needs. (See Iowa, Kentucky, Pennsylvania, Vermont, and Virginia for examples of how this works). By helping enroll students in Medicaid, schools can be paid for many of the services they often already provide to students with special needs.

Schools can take this approach a step further by helping connect whole families to coverage. For example, schools can call the students’ homes or send pamphlets home informing families of new health coverage options. This benefits schools and families: Schools get paid for the services they provide, and families get connected to health coverage.

The Bottom Line

Pursuing these policy options within your school or school district and at the state level is one of many ways to connect families to needed coverage. Check back with us in the next few months as we highlight other outreach best practices.

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