Reach out to Republican leaders in Congress and explain how your district would be impacted by a Medicaid cut


The Advocate, March 2017
Sasha Pudelski, assistant director, policy and advocacy
AASA, The School Superintendents Association

Many superintendents are aware of Congressional Republicans’ twin desires to lower taxes and reduce the federal deficit. What is less understood is that the plan to achieve both goals simultaneously would be through cutting federal expenditures for Medicaid. What they are saying is essentially, “let’s cut healthcare for children in poverty and children with disabilities by providing a block grant to states for Medicaid expenditures, and we can use the federal savings to do tax-cuts and achieve deficit reduction goals.”

Unfortunately, for AASA and other organizations that care deeply about children, we have an uphill battle to convince the GOP on Capitol Hill, as well as the Trump Administration that cuts to Medicaid are not a tenable way of achieving their desired objectives.

AASA is taking an aggressive stance against proposals that would refinance Medicaid and allow the federal government to disinvest by approximately 30 percent from a program that provides critical funding to many school districts. We have launched a coalition called the Save Medicaid in Schools Coalition that is comprised of over 60 education, healthcare and child welfare organizations concerned about how a 30 percent cut to Medicaid programs in schools would impact student achievement and student well-being.

Congress can refinance Medicaid through a Congressional procedure called Budget Reconciliation that only requires simple majorities in both the House and Senate. Therefore, unless we can convince enough Republicans to oppose these measures to restructure and disinvest from Medicaid, we will not succeed in preserving this funding stream to schools.

But now for the really bad news: Under the GOP’s proposal, a state could decide not to allow districts to bill for Medicaid at all. So, in addition to the reduction in federal reimbursement, a state would have control to eliminate all Medicaid payments for districts. Who could afford to continue providing Periodic Screening Diagnosis and Treatment (EPSDT) benefits? Who could afford to continue the important work of enrolling students in Medicaid and connecting students with local healthcare providers?

Our best arguments come from superintendents in the field. AASA, in collaboration with our partners at the Association of Educational Service Agencies and the Association of School Business Officials International, disseminated a survey to school leaders across the country asking them to document how they spend their federal Medicaid reimbursement and what would be at-risk if those dollars were cut.

We received responses from close to 1,000 school leaders in 42 states and the results are what you would expect. Students with disabilities and students in poverty will be hurt by these cuts. In addition, we found out that on average, two-thirds of dollars returning to districts are spent on personnel salaries, meaning that jobs would be at risk if Medicaid dollars went away.

Many school leaders expressed concerns about needing to raise taxes or cut general education programs further to make-up for the special education funding shortfall. Others highlighted how recent attempts to better meet the mental-health needs of students would be dramatically undermined, if not eliminated, as a result of this cut. The full results are found in our January 2017 report, Cutting Medicaid: A Prescription to Hurt the Neediest Children.

The time to act is now. It’s critical you reach out to Republican leaders in Congress and explain to them how your district would be impacted by a cut to Medicaid or the ability of states to eliminate this reimbursement altogether.

Aside from the moral arguments that one could make about reducing health care services to the most vulnerable children in America, there is a practical education and economic argument to make for district leaders. I urge you to do both and to do it quickly.