School lunches and Medicaid: a BFD

This is a Big Biden Deal:

Kids who have enough to eat and are not worried about having enough to eat have two significant advantages over kids who don’t have enough to eat and have to worry about that. The first is simple, they have more energy to spend on high intensity activities of play and learning (speaking as a dad of a first grader, those two things should be very close to the same a good chunk of the time). Secondly and slightly more subtly, kids who are not worried about their next meal are able to devote high complexity cognitive processes to other things. Kids (and adults) have a finite amount of brain horsepower available at any given time. Not worrying about food frees up capacity for other things. Kids who are worried about food are devoting a limited brain budget to that task and not to other things.

The free and reduced price school lunch program in most districts except for high poverty districts like the one my family lives in has a significant amount of paperwork and potential stigma attached. Some of that paperwork will deter people who qualify from signing up. Some proportion of those people who are deterred will have signed up for Medicaid or CHIP. Both of those programs have routine income verification processes. Both of those programs are far more valuable on a cash value basis than school lunches so the cost of not hurdling an administrative barrier is higher and more visible. Compliance is higher.

Allowing states to use pre-exisiting data to pre-qualify kids for free or reduced price school lunches will help a few more kids get a quality daily meal or two in their stomachs which should increase their well being in addition to improving school performance. It is also an example of the government working to actively improve peoples’ lives while streamlining the interaction.

This is a good thing now that it is optional. If we could only make it mandatory that states use Medicaid or SNAP eligiblity data to drive the full array of income qualified social services instead of silo-ing different categories of assistance so duplication and administrative burden increases wasted costs without providing qualified individuals the services and assistance that they need.

49 replies
  1. 1
    Mike in NC says:

    Who’ll be the first winger to denounce this as Big Government Tyranny?

  2. 2
    Diana says:

    Can’t remember where I read this (and google isn’t helping) but some Victorian writer said once that man did not discover he had a soul until he was well fed and enjoying the prospect of that state continuing.

  3. 3
    Schlemazel says:

    Wouldn’t it be better for the kids to not learn dependency on the evil government? Would they not be better off pulling themselves up by their own boot straps to learn self-reliance? If that fails they could eat those bootstraps.

  4. 4
    Mnemosyne says:

    This is a really smart idea. I actually kind of prefer that some schools have basically made lunches free for everyone rather than making it a profit center, but this isn’t bad.

  5. 5
    jl says:

    @Mike in NC:

    ” Who’ll be the first winger to denounce this as Big Government Tyranny? ”

    I’ll be the stunt double, to get it over with: “! denounce this as Big Government Tyranny! ”

    Thanks to RM for the interesting, and good, news. We need more efforts like this to improve effective programs and get them to more people.

  6. 6
    SiubhanDuinne says:

    Tangentially related, because it’s about kids and health: did anyone else see the Rachel Maddow town hall from Flint on MSNBC? One of the horrifying pieces of information to emerge is that NONE of the Flint public schools — not ONE — has a school nurse. There is apparently one nurse for the entire district. School secretaries are the ones who dispense meds (and, I suppose, take temperatures and such). I wasn’t crazy about Flint when I lived there, and that was 40 years ago, but holy shit, it wasn’t anything like this bad back in the day. What a horror show.

  7. 7
  8. 8
    SarahT says:

    @SiubhanDuinne: Unbelievable, right ? What. Did you think of the town all ? I thought it was well done – informative, even for those who’ve been following the story .

  9. 9
    Mnemosyne says:


    Sadly, that’s way more common than you’d think. School nurses (and librarians, and guidance counselors) were all considered expendable when the budget crunch hit. At best, most school districts have 1 nurse who travels between 3 or 4 different schools.

  10. 10
    SarahT says:

    @SiubhanDuinne: Um, town HALL. Stupid phone.

  11. 11
    ThresherK (GPad) says:

    @Diana: My wild guess would be E M Forster. Or maybe Bertrand Russell?

  12. 12
    Gin & Tonic says:

    @SiubhanDuinne: This is not uncommon. Many schools in many states have nurses that cover multiple schools; maybe not as extreme as Flint, but there are often no policies, or policies that “recommend” one nurse per 1,000 students or similar. New Jersey requires one nurse per district, North Carolina requires one nurse per 3,000 students, Michigan has no ratio specified. It’s all over the map.

  13. 13
    NotMax says:

    Cue the right:

    “Oh no, MESS PANELS!”

    “Free lunch creates a culture of dependency.”

    “They force feed the terr-ists at Gitmo, now they want to force feed your children!”

  14. 14
    rikyrah says:

    Thanks for good information Mathew.

  15. 15
    Punchy says:

    But when poor kids get all the T-bones, what kinda steak am I supposed to eat?

  16. 16
    SiubhanDuinne says:


    I agree. Rachel is at her best with stories like this, and there’s such a great cast of characters in this. Dr. Mona, the whistle-blowing paediatrician, is a true hero and I hope at some appropriate point she gets the rewards and recognition she deserves.

  17. 17
    Goblue72 says:

    Good news. Anything to centralize, standardize and automate the eligibility determination for and enrollment into social welfare programs is an unmitigated Good Thing. The rigamorole we put poor people through in this country just to not be starving in the street is shameful.

    As a leftist, I got my beefs with our center-left President. But his push over the last 7 years to modernize and improve the bureaucracy for welfare programs sure isn’t one of them.

  18. 18
    HRA says:


    I watched the show. I was shocked at no school nurses and it seems the audience was shocked, too. I had to check my local school district to see if we still have nurses and we do have them. There is even forms on their site for nurses to apply for jobs. .

  19. 19
    SiubhanDuinne says:

    @Gin & Tonic:

    Well, I had no idea. The town where I grew up (Oak Park, Illinois) had eleven K-8 schools in my time, and every one of them had a full-time school nurse. No idea what the situation is now. I never had kids of my own, so I guess it’s one of those bits of information that was just beyond my radar, but I am horrified.

  20. 20
  21. 21
    SiubhanDuinne says:


    I was shocked at no school nurses and it seems the audience was shocked, too.

    Yes, that struck me too, that it seemed to be news to most of the audience — who are, presumably, locals.

    (In fact, a friend of mine from many decades ago was in the audience. I wouldn’t have thought to look for her, but she had some pix of Rachel up on her FB page, so I watched for her and think I caught a glimpse, and captured a screen grab, of my friend.)

  22. 22

    Meanwhile, I’m stuck in complete limbo on the health insurance front. I got a notice on December 27th that I was being disenrolled from Minnesota Care at the end of that month. For almost a week, it was literally impossible to get through to anyone; the only method of contact was by phone, and when you called, you got a message that, due to the high volume of calls, you needed to try again later. Once I got through to a message that my call would be answered in the order it was received, so I spent an hour on hold before it dumped me to the message to try again later.

    I finally talked to someone about a week into January, who bounced me to MNSure, who bounced me back to Minnesota Care. Finally, someone said that they never received the re-enrollment forms I sent back. He said they would send me a new form. Four days after that, I went through a couple of hours on hold again to make sure that they had been sent, and no one could tell me one way or the other. So, on January 12th, they voided my previous account and told me to reapply online. Which I did.

    Yesterday, I went in to pick up my prescriptions, and the pharmacist told me that they had been unable to get authorization, and the state had refused to pay. So this morning I went back on hold. After a half hour, I talked to a woman, who said she needed to put me on hold to call up my account, which promptly bounced me to the message that everyone was busy and I’d need to call back later. I got that the next several times I tried to call, then finally got someone after a half hour on hold. When I started that conversation off by telling him not to put me on hold, he deliberately disconnected me.

    After another 45 minutes on hold, I got to someone. She said that sometimes people who had applications or policies voided so they could reapply online got stuck in the system. She said someone would need to push it through, but that that someone couldn’t be her. She said she’d start a ticket, and that these things generally got taken care of quickly. I asked her how I would know whether it had gone through, and she told me that I’d receive notification in the mail. I pointed out that I needed to pick up my prescriptions, and that that wasn’t an acceptable answer. She just said that there wasn’t anything else she could do. She wouldn’t even transfer me to a supervisor.

    So, in dealing with this for a month, I have yet to find anyone that exhibits even the smallest amount of competence or anyone who will accept even the slightest hint of responsibility. And, as far as I can tell, I have no health insurance, and I have no way to make sure that I get it.

  23. 23
    Jay Noble says:

    My family qualified for at least reduced meal rates pretty much the entirety of my school years. But my year younger brother and I never took it because of the stigma of having to say in front of friends and classmates “I’m on the list”. Even if you didn’t have to say it, it was obvious the cashier lady was checking you off. My 2 younger sibs (6 and 10 years younger), did take the reduction/free meal but many of their friends were on the list too and it wasn’t such a big deal. I don’t know how she did it but I’ve always been thankful Mom somehow found the full lunch money for us.

  24. 24
    Felonius Monk says:


    now they want to force feed your children

    Not only do they want to feed them, but they want to feed them that healthy food. This is just so Un-Amurcin.

  25. 25
    Mnemosyne says:

    @Tissue Thin Pseudonym:

    I would contact three places, preferably all at the same time: Minnesota’s Department of Health, your representative in your state legislature, and Hearing from any one of those places should light a fire under MNCare’s ass, and hearing from all three would really panic them.

    If the Department of Health just refers you back to MNCare, add in your Congressperson.

    ETA: Also, if any of your prescriptions are must-haves, check Costco’s price — they are usually required by state law to let you fill your prescriptions there even if you’re not a member. Save the receipt, because you should be able to submit it for reimbursement once the mess gets straightened out.

  26. 26
    Mnemosyne says:

    @Jay Noble:

    That’s one of the reasons I tend to prefer it when schools make lunch free for everyone — there’s less stigma if there’s no list.

  27. 27
  28. 28
    Villago Delenda Est says:

    @NotMax: They want to force feed your children lemon chicken. Lemon chicken!

  29. 29
    ThresherK (GPad) says:

    Totally OT but I ran across this ad for a needleless phonograf on Vintascope. Didn’t someone mention it downstairs?

  30. 30
    PurpleGirl says:

    The Rethuglicans will never like this plan. It smacks of government efficiency and success. It will work too well and government can never do anything right in their eyes.

  31. 31
    Gin & Tonic says:

    @efgoldman: Call the Office of the Health Insurance Commissioner, ask for Nicole Renzulli, Administrative Officer, (401) 462-9639.

    I have no idea where you may have gotten this information.

  32. 32
    Alex says:

    @efgoldman and @ tissue thin pseudonym

    I’ll reinforce what was said above: call your state rep or state senator. Even if they are Repubs they should have constituent services staff. They can call the legislative liaison for your state exchanges and escalate your cases.

  33. 33
    David 🍁Canadian Anchor Baby🍁 Koch says:

    Obviously Obama is trying to distract us from Benghazi by feeding poor children.

    Nice try, but it won’t work.

  34. 34
    NotMax says:

    @Villago Delenda Est

    Lemon chicken!

    Probably made in China, too.

    Is there no end to the horrors, to the atrocities?

  35. 35

    I taught for 4 years in a school where 99% of the students were Free and reduced meal kids. The youngest would be about 23 today and I wonder a lot where they all are today.

  36. 36
  37. 37
    slag says:

    @Mnemosyne: Agreed. Free school lunch for all is really the most appropriate solution all around. The administrative costs associated with our current system would be better spent on food for kids.

  38. 38
    Smalla says:

    @Diana: “There are people in the world so hungry, that God cannot appear to them except in the form of bread.” Gandhi

    I also thought of Maslow’s hierarchy of needs.

  39. 39
    Redshift says:

    @Felonius Monk:

    Not only do they want to feed them, but they want to feed them that healthy food.

    Probably on direct orders from Michelle Obama!

  40. 40
    Redshift says:


    The rigamorole we put poor people through in this country just to not be starving in the street is shameful.

    Agreed. The suspicion is so pervasive in this country that someone, somewhere (and when worse if it’s one of Those People) is getting something they don’t deserve with my tax dollars. As a result, we waste vast government resources humiliating the poor, ensuring they’re Truly Deserving, and implementing a patchwork of programs where legislators have decided for them what they really need. (And also wasting private resources in programs that are seeking government grant funding.)

    Meanwhile, countries like Brazil are finding that an effective way to combat poverty is just to give poor people money. Some of it goes to waste, sure, but by and large, poor people have a pretty good idea of what they need, much better than legislators.

  41. 41
    NotMax says:


    A few (far too few) municipalities have belatedly discovered that an extremely effective way to deal with combating and reducing homelessness is to provide housing, not shelters, establishing a semblance of stability to enable working on associated problems.

  42. 42
    Villago Delenda Est says:

    @Redshift: The people who are really getting what they don’t deserve all have seven figure or better incomes.

    Or are living off a trust fund set up by a rich ancestor.

  43. 43
    Badtux says:

    I am baffled. When I was handling the school lunch data processing for a school district in Louisiana, every few months we got a tape from the Feds with a list of kids who were receiving benefits. We then had to match the kids on this tape (no mean feat, parents were notoriously slipshod with things like birth dates and social security numbers and we weren’t allowed to require social security numbers as a prerequisite for enrollment) and then submit the matches to the school lunch program so they could auto-enroll those kids. If the kid was on the tape from the Feds, that’s all the paperwork we needed, the school lunch program didn’t need anything else.

    This was during the Clinton administration. This changed during the Bush administration? And it’s taken this long for Obama to change it back to what it was during the Clinton administration? Or were we operating under a “high poverty” waiver? It’s been a long time and the people involved are long retired so I cannot ask them.

    Meanwhile, the notion of just giving poor people money is a good one. Why is it not okay for government to tell you and I how to live our lives, but fine for government to tell poor people how to live their lives? It makes no sense!

  44. 44
    Mnemosyne says:


    Do you remember which benefits were being matched? The linked article makes it sound like specifically linking Medicaid to free school lunch is the change rather than linking, say, whose family was getting food stamps.

  45. 45
    currants says:

    @Jay Noble: Yes– I was a single parent going through college and grad school, and either packed my kid’s lunch or found a way to make sure she had enough to buy it every week. We moved when I got my first job, where I taught in an extremely high poverty district, and everyone got not just a free lunch, but breakfast too, if they got there early enough. Even my kid, although we were in the high end of the income range there (on my $22k teacher’s salary).

    except for high poverty districts like the one my family lives in has a significant amount of paperwork and potential stigma attached.

    Fear of the stigma added to being hungry really refocuses a kid’s mind in ways not conducive to learning. When we moved back east, my kid went to a school that served lunch to everybody, no questions asked. They also had a snack break in the morning (yes, even through high school), and if you got there early enough, breakfast (which was great for the kids on the hockey team who practiced at 5 am).

    Regular meals are a big deal (and not just for kids). Thank you for highlighting this, Richard.

  46. 46
    Kay says:


    Our school has about 50% free and reduced lunch but it also has a payment system where the kids punch in their student ID to pay. They can’t tell who is free and reduced lunch. The same is true for “school fees” (those are subsidized by the state) and fees for sports and clubs (those are subsidized from local taxes).

    It’s worked out really well. They use one number for everything they do. If you’re in the paying group you get an email when the account is low and they extend “credit”- if a paying student doesn’t have money in the account they give them lunch and subtract it from the next payment.

  47. 47
    currants says:

    @Kay: That’s so much better than some of the options I’ve witnessed. Being humiliated in the lunch line is The.Worst. when you’re a kid, in part because it is usually public and opens you to bullying. And as far as I could tell, the lunch ladies never thought they were doing anything but what they should.

  48. 48
    Badtux says:

    @Mnemosyne: My impression is that it was *any* benefit that went to poor kids that was on the tape. But that was over 20 years ago now (eep! where has the time gone?!) so I’m not sure. And BTW even back then we were cognizant of the issue of kids being stigmatized over free/reduced school lunch, and were doing the lunch pass thing with a bar code scanner and student ID where lunch was prepaid rather than paid at the lunch line. If the kid didn’t have his ID with him he could manually enter his ID number (that’s all that the bar code scanner did anyhow, it was a little widget that plugged into the keyboard port of a PC between the keyboard and the computer) though the lunch lady would fuss at him for holding up the line (of course! lunch ladies, heh). It certainly worked better than the system from when I was in school, where you had lunch money that bullies could steal or a free/reduced lunch pass that was stigma.

  49. 49
    terraformer says:


    Right, this seems like a no-brainer. School is already “free” in the sense that, outside of particular materials (some books, supplies, etc.), taxes pay for school as it is now – so why shouldn’t lunches be “free” too? Removes the social stigma, everyone eats, and as Richard wrote, there is the assurance that the “energy” is there via nutrition and foodstuff for kids to focus on learning and other activities. But that’s the way to a socialist hellhole, right? Damn right it is.

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