How the Bipartisan Safer Communities Act Helped Expand School Medicaid and Student Access to Health Services
August 19, 2026
In June 2022, the Bipartisan Safer Communities Act (BSCA) was signed into law, marking a historic investment in school-based healthcare through provisions designed to increase Medicaid funding.
Four years after its passage, states are documenting significant progress in expanding their school Medicaid program to comply with federal flexibilities and secure additional federal reimbursement.
This report — the first assessment of its kind — examines the key trends, challenges and innovations that have emerged since the BSCA required the Centers for Medicare and Medicaid Services (CMS) to:
• Update school Medicaid billing and administrative guidance
• Establish a school Medicaid technical assistance center to help states and school districts better understand and administer school Medicaid policy
• Release $50 million in state grants to encourage implementing, expanding or enhancing school Medicaid programs
The authors used three indicators to gauge state progress: 1) the number of states that expanded coverage for health services outside the individualized education program (IEP) or are in the process of doing so; 2) whether the investments increased state capacity and support for school district participation; 3) whether states that expanded their school Medicaid program are receiving additional federal funding.
The report also offers recommendations for states and school districts to continue advancing their work and connects these recommendations to current policy issues and opportunities, enabling them to build on their successes.
