Healthcare Reform: What the AHCA and BCRA Mean for Medicaid

Disclaimer: This article was edited on July 17th to reflect the implications of the Better Care Reconciliation Act (BCRA), which is currently under consideration in the Senate. 


In May, the House of Representatives passed the American Health Care Act (AHCA), and the Senate is currently preparing to vote on the Better Care Reconciliation Act (BCRA). Both of these bills will serve to repeal and replace the Affordable Care Act. If passed, they will bring many changes to the federal Medicaid program, including devastating funding cuts. The ACHA proposes cutting $880 billion in federal spending on Medicaid over the next 10 years, while the BCRA proposes a $772 billion cut.

These bills would make two major changes to Medicaid as we know it:

  1. Decrease federal spending on Medicaid by hundreds of billions of dollars
  2. Place limits like per-capita caps on beneficiary groups, including children and individuals with disabilities.

These changes will have devastating implications for schools.

Decreasing healthcare access for all students

The proposed cuts to Medicaid will impact many people, but especially kids. Children make up half of all Medicaid recipients, and public schools currently receive about $4 billion dollars a year in Medicaid reimbursements to pay for things like salaries for school health professionals and equipment or assistive technology for students with disabilities.  And while Medicaid exists to provide services for students who qualify for it, like kids with disabilities and those living in poverty, the changes to Medicaid funding will impact all students.

On any average school day, a student may benefit from Medicaid services without even knowing it. Any student can see a school nurse when they aren’t feeling well, or pay a visit to the school counselor to talk about things that may be troubling them in school or at home. Thousands of these health professionals are paid through the Medicaid program, and the impending cuts put their jobs and these services in jeopardy.

Depleting schools’ already-strained resources

And while the federal government support for Medicaid may be going away, the requirements for schools to meet the needs of students are not. Under the Individuals with Disabilities Education Act (IDEA), schools are obligated to provide medically-necessary services to students with disabilities. For the 1 in 5 students with learning and attention issues, cuts to Medicaid mean further strained resources for getting the help they need to succeed in the classroom.

Because it is the law that these schools continue to provide services for students who need them, schools will be forced to find funding somewhere else. Currently, Medicaid is funded by a federal-state cost sharing model, but the proposed bill would shift much of the financial burden to the states, with one of two outcomes: funds will have to be reallocated from general education programs in order to cover the extra cost, or states will be forced to raise taxes. Diverting funds from other sources in schools does not prioritize the success of all students—instead it forces schools to prioritize one group over the other.

You can help prevent these harmful cuts

A cap on federal investment to the Medicaid program will have devastating impact on all students, no matter where they live, their abilities or what their socio-economic status is. Our schools serve a diverse population of students with diverse needs, and Medicaid is an important component of making sure we are meeting the needs of all students and setting them up for success.

Right now, the Senate is preparing to vote on the BCRA. Before it’s too late, they need to hear from you about how important Medicaid is to our students and schools. Take action now to let them know that your priority is to ensure all students – regardless of their income or level of need – have access to important health screenings and healthcare professionals in schools.

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