This report examines 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 2017-18. Certification, participation and reimbursement outcomes for Cohort 1 states in their second year of implementation and Cohort 2 states in their first year of implementation are discussed.

The Healthy, Hunger-Free Kids Act of 2010 (HHFKA; PL 111-296) required the USDA Food and Nutrition Service to conduct a demonstration that adds Medicaid to the list of programs used to directly certify students for free school meals. Although students receiving Medicaid are not categorically eligible for free meals, the DC-M demonstration authorizes selected States and districts to use income information from Medicaid files to directly certify those students found to be eligible for free meals.

In 2006, FNS asked the Institute of Medicine to review the WIC food packages. The IOM proposed major changes to improve nutrition and encourage breastfeeding but also expressed the concern that changes related to partial breastfeeding may have unintended consequences. The IOM recommended that FNS conduct an impact study evaluating the birth month breastfeeding changes to the WIC food packages.