The impact of the Affordable Care Act (ACA) has been making headlines in recent weeks as elected officials take steps toward repealing it. The news has largely focused on what this would mean for the millions who depend on the ACA for health insurance coverage and on issues like lifetime limits for coverage. Yet one important part of the ACA’s impact has been largely overlooked: the tremendous positive impact it has had in our nation’s schools.
When the ACA became law in 2010, it shifted the focus of our nation’s healthcare system from only treating disease to also preventing illness and promoting health. As Dr. Regina Benjamin, U.S. Surgeon General at the time, said: “Health does not occur in the doctor’s office or the hospital only—it also occurs where we live, where we learn, where we work, where we play and where we pray.”
With this shift, our healthcare system began to increasingly prioritize community-based care, care coordination and ongoing chronic disease management. It brought new opportunities—and motivations—for the health sector to engage with and support schools through innovative partnerships. When it comes to a federal requirement that hospitals provide measurable benefits to the communities they serve, the ACA strongly encourages hospitals to go beyond providing free care to uninsured patients and creates an expectation that they invest in the health of their surrounding communities. If a hospital has identified obesity and asthma as health needs in its community, for example, that hospital may invest community benefit resources in school physical activity programs, nutrition education and school nursing focused on asthma management. This investment can be life-changing for students: Time spent in a first-grade reading lesson instead of at the emergency room can profoundly shape a student’s academic success for years.
In addition to this big-picture focus on partnerships and health promotion, the ACA supports student health and wellness in a number of specific and powerful ways. For example, the ACA expands Medicaid eligibility, which means more students can regularly access the basic care they need to be healthy and attend school. It includes funding for school-based health centers and programming for pregnant and parenting teens. It also holds health systems accountable for metrics related to prevention; these metrics are driving hospitals to develop productive partnerships with schools, because schools can play a role in helping health systems meet these goals—with benefits for student health.
These supports for school health have a simple and powerful result: Students are able to stay healthy, and they are able to stay in the classroom and learn.
If the ACA is repealed, schools will lose these key resources—from funding to the support of successful innovative partnerships—that so directly support students’ health and learning. While losing these resources, schools would be in the position of struggling to meet the needs of an increased number of students who would lose health coverage their families received through the ACA (either through Medicaid or the insurance marketplace) so those students could be healthy enough to attend and participate in school.
The partnerships and funding provided by the ACA created an environment in which schools were able to make great strides to support student health in a sustainable and cost-effective way. These programs have been a success. Repealing them would mean rolling back proven supports for vulnerable children while increasing the already-weighty burden we place on our nation’s schools.
HSC is closely following this issue and is prepared to speak up in defense of the valuable supports the ACA provides to our nation’s schools. We’ll be sharing updates as this work continues.