At Malta Elementary School in DeKalb, Stephanie Schmitt guides one of her students through a speech lesson. She’s a speech-language pathologist.
“Oh, let’s make it a little harder,” she says to the student. “Do you like to play in the snow? Can you say ‘I play in the snow?'” The student repeats back ‘I play in the snow’ more confidently each time until they get it just right.
Speech is one of many education services schools rely on Medicaid to help pay for. Teachers like Schmitt provide therapy, and Medicaid reimburses the school a certain amount to help re-coup the cost. Medicaid is K-12 education’s fourth-largest federal funding source.
Lisa Davidson-Becker is the DeKalb School District’s assistant director of student services.
“So, for example, in fiscal year 2023, we were able to get reimbursed just over $800,000, so, it is a significant amount,” said Davidson-Becker. “We’re able to use some of that money to offset some of the costs for the salary for some of our related services, speech pathologists, nurses, things like that.”
She says they can also use the money to buy assistive technology and therapy tools.
More than 330,000 Illinois residents are projected to lose Medicaid coverage due to the new “One Big Beautiful Bill Act.” While the new law doesn’t directly cut Medicaid funding, people are expected to lose coverage because it adds extra paperwork to keep proving employment status.
The state taxes providers like hospitals to help cover the cost of services paid with Medicaid dollars. But the new law also limits how much they can tax those providers and it stops the state from creating new taxes.
The nonpartisan health policy group KFF projects it will lead to a roughly $46 billion decline in Medicaid spending in Illinois over the next decade — including less money for schools.
In a recent nationwide school survey, 70% of respondents said they expect Medicaid cuts would result in reductions and layoffs of school health staff, and over 60% said they’d expect a reduction in resources like assistive tech for kids with disabilities.
In DeKalb, Davidson-Becker says it’s still too soon to know the new law’s impact. But she says the need for these services grows every year.
“We’re certainly ready to still provide those services,” she said. “But we’re going to have to be creative on how we would fund those if we see Medicaid cuts.”
That’s not the only way Medicaid intersects with the education system. Medicaid is also the second-largest funder of early intervention services in Illinois.
Early intervention provides developmental services like speech and occupational therapy for children up to three years old. About half of children receiving these services in Illinois use Medicaid.
Haley Mason is an adjunct professor at Aurora University. She spent 17 years as an early intervention service coordinator.
“The systemic issue here is not just losing the Medicaid dollars,” she said. “You’re losing providers, you’re losing hospitals and therapy locations where these children are able to receive services that are paid by early intervention. In rural areas, we’re already at a shortage of providers spread across how many children they have to treat.”
Right now, Illinois children qualify for early intervention when they have a delay of 30% or greater in a certain developmental area, whether it be cognitive, physical or communication. Mason’s worried that if the cost burden is shifted more on the state, they might have to raise the threshold for qualification, which would mean fewer kids receiving therapy.
“I’m so far above any level of concern that would be on a chart,” said Mason. “Scared is probably the best word to describe [it]. I am angry and scared that people don’t understand the impact of these cuts.”
She says Medicaid is also crucial to providers because those reimbursement rates have gone up over the past few years, while some payouts from private insurance have decreased.
Overall, Mason says these cuts will cost taxpayers money, because when children don’t get early intervention, they end up requiring more expensive services later on.
In a statement to WNIJ, a spokesperson for the Illinois Department of Human services said they’re concerned that federal Medicaid cuts will shift more of the cost to the state, which could make the system unstable for providers and reduce access to early intervention.