Medicaid to Schools and the Role of the State Board
January 16th, 2026
Notes from the Margins:
What a whirlwind of a week! The pace in the House has been fast and furious, and there’s been no shortage of scandal.
In this segment of the blog, “Notes from the Margins,” our goal is to provide a little insight into the trends we’re noticing, the moments that jumped out to us, or the things we’re thinking about as the legislative process unfolds. It’s a place to zoom in and zoom out, and to talk about bills that might not be in the spotlight or interesting moments you might have missed. To that end, here are a couple things that jumped out at me this week:
Differences of opinion on Medicaid to Schools?
First, a very quick Medicaid to Schools primer. When a Medicaid-eligible student receives Medicaid-eligible services through a care plan or an Individualized Education Plan (IEP), the school can seek reimbursement for those services through the Medicaid to Schools program. The NH Medicaid to Schools Resource Center is a great resource for more information.
So, why are we talking about it? Medicaid to Schools came up in two hearings this week. First, on Wednesday, the Education Policy and Administration Committee heard HB 1640 (Rep. Murray), which would allow school districts to obtain an annual parental consent form to bill Medicaid for eligible students. And on Thursday, the House Education Funding Committee heard testimony on HB 1563 (Rep. Ladd), which would change the special education aid formula. We wrote a bit about this hearing here, but key for this discussion: the bill would require school districts to demonstrate that they have accessed all possible sources of revenue for special ed, including Medicaid. Legislators who attended a meeting at the NH Department of Education on Tuesday heard from Medicaid Director Harry Lipman that the state is leaving Medicaid to Schools money on the table, and it’s clear lawmakers on both sides of the aisle are sensitive to it.
At the same time, however, both the House and the Senate have passed SB 34, which would require schools to obtain parental consent for each new service offered under Medicaid to Schools. This bill will make it more administratively complex for schools to utilize Medicaid, and also could result in smaller reimbursements. As explained in testimony at Wednesday’s hearing, Medicaid to Schools is a reimbursement mechanism, not a service provision mechanism. When a parent signs an Individualized Education Plan (IEP) for special education, the school is committed to providing those services, and can seek reimbursement for qualified services through Medicaid to Schools. If a parent does not authorize Medicaid reimbursement, the student still receives the services authorized by the IEP, but the school doesn’t receive the money. Abiding by SB34, should it become law, might in fact require schools to leave Medicaid money on the table, despite the insistence of the Education Funding Committee that they do the opposite.
Who’s in charge at the state level?
One of my favorite moments this week came from NH Department of Education Attorney Elizabeth Brown, responding to a question from Rep. Murray about the difference between the NH Department of Education and the State Board of Education. This is a distinction that is fuzzy to many, and is certainly blurred in many bills and laws. If you share in this confusion, watch the short clip here.
An unexpected non-germane amendment
In the floor session last week, Sen. Lang alluded to an amendment to SB 101, the open enrollment bill, that he planned to bring to the Finance committee. We are still awaiting that amendment, but in the meantime, Sen. Lang has offered a non-germane amendment that would fix the language in the parental bill of rights, passed last session, that prevented schools from recording and broadcasting athletic competitions and holiday concerts. The Senate Finance Committee will hear that amendment on Tuesday.
Next week is a big week
If you thought the pace this week was hectic, just wait until next week. With multiple key hearings happening simultaneously, it could be hard for legislators and advocates (and policy analysts) to keep up. Here’s what’s happening and the key bills we’re tracking at each hearing:
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Tuesday, January 20
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SB 578: extending recess for students from kindergarten to eighth grade and prohibiting the deprivation of recess time as punishment in schools
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HB 1826: relative to the cost of an opportunity for an adequate education
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HB 1831: repealing the education trust fund targeted aid cap
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HB 1827: establishing a grant program to support school districts’ extraordinary needs and fiscal capacity disparities relative to providing an adequate education
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HB 1799: relative to required state funding for providing an opportunity for an adequate education
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Non-germane amendment on SB 101
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Wednesday, January 21
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Thursday, January 22
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SB 584: increasing the amount of funding provided for students receiving special education services
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SB 491: enabling students to utilize education freedom account funds to pay for certain career and technical education funding
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SB 582: modifying the base cost of an adequate education
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SB 581: modifying EFA eligibility and removing priority guidelines and the enrollment cap
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House Education Policy and Administration (Executive Session)
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HB 1264: increasing the requirements of the education freedom savings account oversight committee and modifying the purpose of the committee
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HB 1507: requiring schools to provide a minimum amount of time for recess per day
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HB 1716: relative to the academic accountability of education freedom accounts.
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HB 1819: relative to review of education freedom account service providers
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HB 1820: requiring the department of education to administer the education freedom account program
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HB 1834: relative to the education freedom account enrollment cap
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Friday, January 23
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