Direct Certification with Medicaid for Free and Reduced-Price Meals

Project Overview

Under the Healthy Hunger-Free Kids Act of 2010 and the Richard B. Russell National School Lunch Act, the Food and Nutrition Service conducted a series of demonstration projects to evaluate the use of Medicaid data to identify students eligible to receive free or reduced-price meals through the National School Lunch Program and the School Breakfast Program. Seven states participated in school year 2016–2017 demonstrations and eight more States joined the demonstration in school year 2017–2018. The demonstrations were designed to expand student access to school meals, reduce administrative burden on districts and schools, and improve certification accuracy.

The evaluation of these demonstrations had five components:

  • Describe the processes, challenges, and successes in matching Medicaid data with school enrollment data.
  • Identify the potential to reach students not directly certified through another program (e.g., the Supplemental Nutrition Assistance Program, the Temporary Assistance for Needy Families program).
  • Identify the potential to reach students enrolled in free or reduced-price schools based on a household application.
  • Identify the effect of the demonstrations on school meal participation, federal reimbursement costs, and state administrative costs.
  • Show how changes to the Medicaid eligibility determination process under the Patient Protection and Affordable Care Act of 2010 affect the ability of states to identify and directly certify eligible children.

For this work, Insight—

  • Evaluated the seven States participating in Year 1 of the demonstration (school year 2016–2017)
  • Led qualitative data collection and analysis for these states, including site visits to State Agencies and four school districts in each state
  • Conducted semistructured telephone interviews with state and school district staff at the end of each school year to ensure a complete understanding of how direct certification with Medicaid for free and reduced-priced meals is conducted
  • Led observations of direct certification operations

The final report examined the impact of using Medicaid data to directly certify students for free and reduced-price school meals in the National School Lunch and School Breakfast Programs in 15 states in school year 2017–2018.


Final evaluation report