Medicaid plays a significant role in supporting students with disabilities by financing health and related services delivered in school settings that help children access and benefit from special education. Under federal law, state Medicaid programs may reimburse for covered services provided to Medicaid-enrolled children when those services are medically necessary and included in a child’s Individualized Education Program (IEP) or, for infants and toddlers, an Individualized Family Service Plan (IFSP).
MACPAC conducted an analysis to examine how children with special education plans experience the Medicaid system. Using 2022 and 2023 data from the National Survey of Children’s Health, we examined differences in reported health status, access to care, and use of services between students with IEPs and IFSPs who are covered by Medicaid or the State Children’s Health Insurance Program (CHIP), covered by both Medicaid and private coverage, and those with private coverage. We also stratified the results for Medicaid or CHIP-covered children with IEPs or IFSPS by race and ethnicity.
MACPAC identified differences in population characteristics between students with Medicaid and CHIP and those with other sources of coverage. For example, children covered by Medicaid and CHIP were more likely to receive necessary mental health care services, were less likely to have out-of-pocket costs for treatment, and to have adequate current insurance coverage compared to children with both Medicaid and private insurance and children with private insurance only.