For some kids, the school nurse is there to put a bandage on a skinned knee or check for a fever. But for a majority of Black students, too often, that nurse is the only healthcare provider they’ll see all year. If House Republicans get their way, though, even that might disappear.
Indeed, Medicaid is the largest federal funding source for school-based health services. And with GOP lawmakers inching closer to passing the One Big Beautiful Bill Act, the health safety net it provides students could be ripped away.
The budget bill, a cornerstone of President Donald Trump’s domestic agenda, slashes at least $715 billion from Medicaid. That means school-based health services funded through Medicaid, such as speech therapy, occupational therapy, mental health counseling, and behavioral health care, could be greatly reduced or eliminated entirely.
“It would be unacceptable and unethical to take that away from our kids,” Lauren Reliford, policy director at the Children’s Defense Fund, tells Word In Black, “Cuts like these will be particularly harmful for children who live at the intersection of race, ethnicity, citizenship status, gender identity, and disabilities.”
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School Is the Only Place Some Kids Get Care
According to the Economic Policy Institute, more than half of all Black children under age 19 rely on public health insurance like Medicaid. For some, this means coverage outside of school — doctor’s visits, prescriptions, and other care. But for many Black students in under-resourced schools, school is often the only place they can get health services at all.
Black students are more likely than their white peers to be enrolled in school-based Medicaid programs. In 2023, 51.2% of Black children received healthcare through these school-based health centers (SBHCs), compared to just 23.8% of white children.
SBHCs, which offer a range of services — including annual physicals, dental care, and mental health counseling receive federal Medicaid reimbursement to defray their operating costs. This is especially the case in low-income, majority-Black districts where students often qualify for public health insurance.
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The Academic Benefits
In a recent study published in the Research Journal of Adolescent Health, researchers noted that SBHCs “support children’s school function by addressing health concerns that might get in the way of students’ academic success without requiring them to leave campus and miss school.” Researchers also found that SBHCs are linked to improved GPAs and higher graduation rates.
A 2023 study conducted by The Los Angeles Trust for Children’s Health and partners found that students who got healthcare at school gained 5.4 to 7 additional school days of attendance per year. And in New York City, a study of school-based health centers found a positive correlation between access to health centers and student performance in English Language Arts (ELA).
If these services disappear, experts warn that Black students — who already face higher rates of school-based trauma and fewer support systems — risk being pushed further behind.
Meanwhile, districts are already bracing for the impact if the One Big Beautiful Bill Act becomes law. A March survey by the School Superintendents Association found that nearly 70% of district leaders anticipate having to cut school-based mental and behavioral health services if Medicaid is reduced or eliminated.
And for Black and Brown children, who are already often failed by the educational system, Reliford says taking away that care is not just negligent — it’s dangerous.
“Every child deserves access to healthcare for their body and mind,” she says, “This is an intolerable scenario that the nation’s lawmakers must do everything in their power to avoid. We must demand better for them — and from those in power.”
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