On March 6, 2017, Republicans in the House of Representatives introduced their healthcare legislation, ”The American Health Care Act” that would repeal the Affordable Care Act (ACA). Almost immediately, the bill moved to the committees of jurisdiction, which are Ways and Means Committee and Energy and Commerce Committee. This bill as it is currently written would dramatically change Medicaid’s structure through a per capita cap which places a limit on the amount that a beneficiary may receive or a block grant which is a lump sum.
Moreover, the cost-savings from the bill will come solely from reductions in Medicaid. On March 13, 2017, the Congressional Budget Office (CBO) issued a budget estimate of the “cost” of the bill, including any savings from the bill. According to CBO, the GOP bill would cut $880 billion to Medicaid over the next decade by changing the structure of Medicaid, as well as rolling back the expansion of Medicaid in the 25 states that decided to expand Medicaid coverage. CBO states the legislation would reduce the federal deficit by $337 billion.
In the next year, it is estimated that 14 million people would either lose their health insurance because they couldn’t afford it or would chose to not purchase it. Over the next decade, 24 million people would cease to be covered.
Following the CBO score, the goal of the Republican House Leadership is to take ”The American Health Care Act” to the floor and complete the process. Then in the Senate, Majority Leader Mitch McConnell would then fast track the bill to the floor of the Senate, bypassing any Committee hearings.
Schools are part of the safety net for children and Medicaid plays a significant role, particularly in the funding of needed medical services for children in special education under IDEA through their IEP, but also for those students without IEPs who are eligible for Medicaid. Medicaid reimbursement to schools for the healthcare of children generates between $4 -5 billion a year or approximately one percent of all Medicaid funds
These changes will impact the ability of students with disabilities and students in poverty to receive many critical health services in schools that enable them to learn. This includes services provided by the school nurse for example vision and hearing screenings and management for students with diabetes and asthma. Additional services affected are mental and behavioral health, speech-language pathology, occupational and physical therapy, and essential equipment for students including wheelchairs and hearing aids. Schools are able to provide these professional services because Medicaid covers the majority of the costs.
National Association of School Nurses
March 21, 2017
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