What the Affordable Care Act Means for K-12 Schools
Students across the country are busy settling into the new school year. When people think “back to school” they don’t usually think “health,” yet academics and health are related. For example, student health and well-being have been positively linked to students’ academic outcomes, including grades and test scores.1 Conversely, health problems can lead students to miss more days of school, pay less attention in class, and learn less.2 Students with poorly managed chronic illnesses (such as asthma, early-onset diabetes, and tooth decay) and those suffering from depression, substance abuse, or obesity are among those at risk of negative academic consequences.3
The Affordable Care Act (ACA), passed in 2010, has far-reaching implications for America’s youth and strives to support their health through a range of programs and provisions. The Act supports three health strategies that are directly implemented through elementary and secondary schools.
- School-Based Health Centers: The law funded the School-Based Health Center Capital Program, which provides $50 million a year for four years (2010 through 2013) for one-time funding for construction, renovation, and equipment for SBHCs. With these dollars, SBHCs in 47 states, the District of Columbia, and Puerto Rico address needs such as modernizing or building new facilities, purchasing equipment, and increasing access to health services for children. Funding preference was given for SBHCs that serve a high number of children with Medicaid or Children’s Health Insurance Program (CHIP).
- School-Community Health Partnerships: The ACA supports school-community health partnerships via the school-based dental sealant programs (the law mandates grants to all states and tribal entities to institute such programs) and the Prevention and Public Health Fund (PPHF – and the many programs that it funds). PPHF provides expanded and sustained national evidence-based investments in prevention and public health, including community and clinical prevention initiatives, public health infrastructure, immunizations and screenings, and tobacco prevention. Efforts are executed in partnership with states and locales that are using funds for a range of public health activities.
- Support for Expectant and Parenting Teens: The ACA created the Pregnancy Assistance Fund, a competitive grant program administered by the Office of Adolescent Health within the U.S. Department of Health and Human Services. This program provides expecting and parenting teens (and adults) with a network of supportive services to help them complete high school or postsecondary degrees and gain access to health care, child care, family housing, and other critical supports. The program also provides funding to states and tribes to improve services for victims of domestic violence, sexual assault, and stalking. States and tribes can use awards to fund programs in high schools and community centers or institutions of higher education.
These three strategies are described in further detail in this recent brief authored by Child Trends for the National Center for Safe and Supportive Learning Environments. The brief provides information on best practices for these strategies and discusses how the ACA can best support their implementation.
Outside school doors, the ACA will impact student health and well-being. For one, the eligibility parameters of Medicaid and CHIP are expanded, meaning more children and youth have health coverage, and many preventive-care services are now covered at no cost to subscribers. Also, though it’s likely not at the forefront of many kids’ minds, a big change is on the horizon for many of their families. Open enrollment for individuals on the Healthcare Marketplace begins October 1st. Individuals in every state will be able to determine whether they can get lower-cost coverage for themselves and their families based on income. They can also compare coverage options side-by-side and enroll in a plan.
 California Department of Education. (2005). A study of the relationship between physical fitness and academic achievement in California using 2004 test results. Sacramento, CA: Author.
Haas, S. A., & Fosse, N. E. (2008). Health and the educational attainment of adolescents: Evidence from the NLSY97. Journal of Health & Social Behavior, 178-192.
 Fowler, M. G., Johnson, M. P., & Atkinson, S. S. (1985). School achievement and absences in children with chronic health conditions. Journal of Pediatrics, 683-687.
 Halterman, J. S., Montes, G., Aligne, A., Kaczorowski, J. M., Hightower, A. D., & Szilagyi, P. G. (2001). School readiness among urban schildren with asthma. Ambulatory Pediatrics, 21-25.
Hannonen, R., Komulainen, J., Riikonen, R., Ahonen, T., Eklund, K., Tolvanen, A., & al., e. (2012). Academic skills in children with early-onset Type 1 diabetes: The effects of diabetes-related risk factors. Developmental Medicine & Child Neurology, 457-463.
Hishinuma, E. S., McArdle, J. T., & Chang, J. Y. (2012). Potential causal relationship between depressive symptoms and academic achievement in the Hawaiian high schools health survey using contemporary longitudinal latent variable change models. Developmental Psychology, 1327-1342.
Jeynes, W. H. (2002). The relationship between the consumption of various drugs by adolescents and their academic achievement. American Journal of Drug & Alcohol Abuse, 15-21.
Pan, L., Sherry, B., & Blanck, H. M. (2013). The association of obesity and school absenteeism attributed to illness or injury among adolescents in the United States, 2009. Journal of Adolescent Health, 64-69.
Selrawan, H., Faust, S., & Mulligan, R. (2012). The impact of oral health on the academic performance of disadvantaged children. American Hournal of Public Health, 1729-1734.