Using Medicaid Data to Help Kids Eat at School

A new initiative by the U.S. Department of Agriculture (USDA) to combat childhood hunger adds to the momentum around ensuring children have the nutrition they need to thrive by allowing states to use Medicaid data, such as family size and income, to directly certify children as eligible for free or reduced price school lunches. Research continues to show that children perform better in school when they are food-secure and that low-income families receiving food assistance have improved health and well-being. In late 2015, the American Academy of Pediatricians released a policy statement encouraging all pediatricians to screen children for food insecurity, recognizing the link between access to food and children’s healthy development.

This new direct certification option, which permits children to enroll without having to bring in a paper form with their parents’ income, will be available for five states in the 2016-2017 school year, and up to 20 states in total over the next three years. Results are promising from the five states that piloted Medicaid direct certification during the 2012-2013 school year. This pilot was conducted prior to the full implementation of the Affordable Care Act (ACA) and before the development of many new Medicaid enrollment and eligibility systems in states. Given the progress states have made on Medicaid enrollment since the ACA, it is possible that future direct enrollment strategies for the school lunch program will produce more significant outcomes.

Using Medicaid data to certify eligibility for the school lunch program will reduce the burden of applications and paperwork on families, school districts, and states. Children in families earning up to 130 percent of the Federal Poverty Level (FPL) are eligible for free school lunches and those in families with income between 130 and 185 percent of the FPL are eligible for reduced price lunches. Children’s eligibility for Medicaid is at least 133 percent of the FPL, and higher in many states. The overlap in income eligibility guidelines makes the new USDA initiative an especially promising tactic to identify eligible children for the school lunch program.

In addition to facilitating certification and reducing burdens on school administrators and parents, this new initiative also has potential to reach students who are less likely to enroll in the school lunch program, such as older students. With this new targeted enrollment strategy, states will be able to identify eligible students who have not signed up for the school lunch program.  However, this approach will not reach all eligible children, including those who are uninsured, have private insurance, or are undocumented and don’t have access to Medicaid.  Therefore even if states adopt direct certification, they must continue traditional forms of enrollment.

This is another example of the gains that states can achieve by using the information already available from one program to enroll or renew eligibility for another program.   Advocates, school administrators, and states should consider applying to be part of the direct certification program.