Do all humans use round-number anniversaries as an excuse to look back at important milestones, or is that uniquely American? This month marks 25 years since September 11, and it has already been 10 years since the Cubs broke their losing streak and won the World Series. The Co-op’s timeline occasionally merits a look back, too, and this year, we’re celebrating 20 years of our Medicaid program.
Medicaid is a joint federal and state health insurance program that provides coverage to low-income children and families, individuals with significant disabilities, pregnant women, and seniors. Medicaid also covers some of the health-related services provided to students with disabilities in public schools. In DC, the program is overseen by the Department of Health Care Finance (DHCF), with support from OSSE. When school-based Medicaid was being implemented in DC schools, the Co-op advocated for charters, reminding District leaders that the “public” in public health insurance most certainly included public charter schools.
In 2006, the Co-op figured out how to submit Medicaid claims using an antiquated paper-and-pencil system and began billing on behalf of several member schools. As you might imagine, the process was extremely time-consuming, but it allowed the Co-op to build extensive experience working with DHCF and other stakeholders.
Several years later, in 2014, the Co-op moved to an online billing platform, giving members electronic access to their Medicaid reimbursement details. By working as a consortium, the Co-op made access to a compliant billing system both affordable and efficient, when it otherwise might have been out of reach for many individual LEAs.
By 2017, the Co-op had helped member charter LEAs recover more than $1.5M in Medicaid reimbursement!
The program had grown to 18 member LEAs by 2021, and the Co-op decided it was time to hire a dedicated staff member to support partner LEAs through every step of the process, including provider enrollment, cost reporting, and cost-settlement audits.
Today, the Co-op serves 36 member LEAs and helps bring more than $8 million in Medicaid reimbursement back to the charter sector each year. Over the past 20 years, the Co-op has gone from navigating paper claims to becoming the trusted expert in Medicaid billing for DC public charter schools.
Of course, we can’t talk about Medicaid without acknowledging the current climate. Under the One Big Beautiful Bill Act, individuals will face stricter eligibility requirements and more frequent enrollment renewals. These changes are expected to reduce Medicaid enrollment and federal spending.
There has also been considerable concern about potential reductions to federal Medicaid funding. In DC, the federal government currently covers approximately 70% of Medicaid costs, with the District contributing the remaining 30% through local funds. If the federal contribution were reduced, states and the District would need to provide additional local funding or reduce overall coverage. Although that has not happened, the possibility is deeply concerning to us because it could leave our member LEAs with fewer resources to serve students with disabilities.
We’re proud of how far the program has come and of the support it continues to provide to our members. We’ve also invited several school leaders to share their experiences partnering with the Co-op’s Medicaid program, and we’ll feature their perspectives in our next newsletter.
