Public Health · Pediatrics · 3 h ago
Medicaid Direct Certification Linked to Increased School Lunch Participation in Maryland
A cohort study of 1,252 Maryland public schools linked Medicaid-based direct certification to increased eligibility for subsidized meals and school lunch participation. Participation rose by 1.9 percentage points among non–Community Eligibility Provision schools and 6.5 percentage points among schools newly participating in that program.
- Cohort study included 1,252 Maryland public schools.
- Medicaid-based certification increased meal eligibility and CEP enrollment.
- Lunch participation rose 1.9 percentage points in non-CEP schools.
- New CEP participants saw a 6.5-percentage-point increase in lunch participation.
A JAMA Network Open cohort study examined Maryland’s implementation of Direct Certification with Medicaid (DCM) in the 2022-2023 school year. DCM uses Medicaid participation to automatically qualify students for free or reduced-price meals and informs eligibility for the Community Eligibility Provision (CEP). Researchers used publicly available school-level data from 1,252 public schools and fixed-effects models to assess changes in certification, CEP eligibility and enrollment, and lunch participation.
Mean Identified Student Percentage increased from 25.9% in 2021-2022 to 37.3% in 2022-2023. In 2023-2024, CEP eligibility and enrollment increased by 26.7 and 22.2 percentage points, respectively. Among non-CEP schools, lunch participation increased by 1.9 percentage points after DCM implementation (95% CI, 1.1-2.8). Among schools newly participating in CEP, lunch participation increased by 6.5 percentage points (95% CI, 4.6-8.3).
The findings suggest Medicaid-based certification may support school meal access following the end of pandemic-era universal free meals in most states. However, this observational, school-level analysis establishes associations rather than causation. Outcomes concerned program access and meal participation, not directly measured student health or academic benefits; the findings are specific to Maryland.
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JAMA Network Open: Direct Certification With Medicaid and School Lunch Participation Among Maryland Public Schools ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.