BACKGROUND: From January through June 2009, 6.1 million children were uninsured in the United States. On average, students with health insurance are healthier and as a result are more likely to be academically successful. Some schools help students obtain health insurance with the help of school nurses.METHODS: This study assessed public school nurses' knowledge and beliefs of the impact of health insurance on students' health and academic success. The study also determined whether public school nurses or their schools were involved in helping students obtain public health insurance, and if so, how they did so. Additionally, the study assessed the public school nurses' perceived benefits of and barriers to helping students obtain public health insurance. A paper-and-pencil survey was sent to a national random sample of 750 public school nurses. The response rate was 56%.RESULTS: Nearly 60% of respondents had helped students enroll in public health insurance. The majority perceived that helping students obtain public health insurance would reduce school absenteeism (90%), improve attention during school (84%), reduce the number of students held back (80%), reduce school dropouts (72%), and increase academic test scores (69%). Although the majority (53%) of nurses thought schools should assist students' parents with filling out public health insurance enrollment forms, some expressed reservations about the process.CONCLUSION: School nurses indicated health insurance is important for the health and academic success of students. These beliefs are congruent with state Child Health Insurance Program (CHIP) directors' perceptions, yet few schools have taken on the role of facilitating student enrollment in public health insurance programs.