Policy Considerations for California Following the 2014 Reversal of the Medicaid “Free Care Rule”

Prepared for the California School-Based Health Alliance with support from The California Endowment

January 2016 – In December 2014, the federal Centers for Medicare & Medicaid Services (CMS) reversed a long standing policy commonly referred to as the “Free Care Rule,” officially permitting Medicaid reimbursement for health care services provided to Medicaid enrollees in schools. The new policy represents an opportunity for schools in California to improve children’s access to health care services and takes the first step toward coordinating these services with the broader health care delivery system. This report, developed for the California School-Based Health Alliance with support from The California Endowment, describes the federal policy change, explores California’s implementation activities to date, and provides recommendations for state policymakers to maximize the opportunity for improving children’s health.