In the 2024-2025 school year, students at New York’s P.S. 5 visited their school-based health center (SBHC) 3,335 times. Many of the nearly 400 low-income children received care for chronic conditions, from daily insulin injections to treatment for sore throats and stomachaches. Others came for dental care or simply to talk about their feelings.
The SBHC is managed by Children’s Aid, a nonprofit dedicated to fighting poverty and enhancing child welfare since 1853. This organization operates multiple SBHCs across underserved neighborhoods in New York City, providing services to children aged three to twenty-two. Families don’t directly pay for these services; instead, funding comes from federal Medicaid, state support, and donations.
However, proposed Medicaid cuts threaten the future of SBHCs across the country. With about 4,000 clinics nationwide, advocates from the Healthy Schools Campaign warn that funding reductions will force schools to reallocate money from other educational programs.
Medicaid and the Children’s Health Insurance Program (CHIP) currently cover 37 million children under nineteen. Since 2014, schools have billed Medicaid for various therapeutic services, allowing them to receive federal funding even without an SBHC. Losing this revenue could have dire consequences, according to education experts.
A report from March 2025 highlights that 20% of children under eighteen face physical or mental health challenges. These cuts will significantly impact low-income children, particularly kids of color, leading to increased absenteeism and dropout rates—outcomes that could be avoided with adequate support from school staff and SBHCs.
Robert Boyd, CEO of the School-Based Health Alliance, emphasizes that while SBHCs are still uncommon, they play a crucial role in reducing health disparities. He adds that among these centers, services can vary widely. Some are fully integrated into schools, while others operate off-site or connect with students via mobile health units and telehealth options.
The importance of SBHCs is underscored by their connection to Federally Qualified Health Centers (FQHCs), which offer higher reimbursement rates from Medicaid compared to other providers. This funding model is now at risk due to cuts proposed by the Trump Administration’s recent budget bill, which places states in a difficult position: allocate funds to maintain school health programs or cut back on services.
Colin Reusch, of the health equity group Community Catalyst, notes that states could lose millions over the next decade, leading to a crisis in school health delivery. Many of the students relying on SBHC services come from racial or economic minorities, making the cuts particularly harmful.
The staff at P.S. 5 are actively advocating for their center, with director Michelle Avila sharing that they are working tirelessly to inform legislators about the critical nature of their services. Pediatrician Lauren Jen points out that SBHCs operate on tight budgets, and further cuts could lead to some centers shutting down. She emphasizes that when children can’t access care at school, they may end up in emergency rooms—often with hefty bills for uninsured families.
Jen describes the vital role SBHCs play in maintaining students’ health, allowing them to stay in school and succeed. “It’s joyful work,” she adds, highlighting the fulfillment of being a supportive figure in children’s lives.
This situation serves as a reminder of how intertwined health and education are. Whether through reports like the March 2025 findings or the ongoing discussions around funding, it’s clear that without adequate support, the health and futures of many children hang in the balance.
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Dispatches,Health Care,Eleanor J. Bader,Schools
