Legislative Affairs

As the 115th Congress kicks off, Republicans are working with President-elect Donald Trump on a plan to repeal the Affordable Care Act (ACA) and reform entitlement programs including Medicaid. The GOP wants to change Medicaid's financing structure to either a per capita cap or block grant. Either proposal will likely:

• Decrease total Medicaid funding available for school-based Medicaid service reimbursements,
• Limit healthcare coverage for students,
• Weaken districts' ability to utilize funding for critical health/wellness services and providing professionals in schools who can serve all students.
• Jeopardize districts' ability to comply with the Individuals with Disabilities Education Act (IDEA) since many use Medicaid reimbursements to pay for services provided by specialized instructional support personnel.

In response, ASBO International is working together with AASA-The School Superintendents Association to advocate against changing Medicaid's financing structure. We are distributing a short joint survey for school business officials, superintendents, and other school leaders to provide feedback about their school-based Medicaid programs and how a block grant or cap would affect their district. Please consider taking the survey and sharing it with your colleagues before it expires on January 9.

A new ASBOUSA blog is available about Republican plans to reform and refinance the Medicaid program, which includes implications for state Medicaid funding and reimbursements to schools for school-based Medicaid services. The blog also highlights ASBO International's position and advocacy activities regarding refinancing the Medicaid program, resources to learn more about how Medicaid funding impacts states/schools, and information about the "Save Medicaid in the Schools Coalition (SMISC)," which we joined to strengthen our advocacy efforts.

For further alerts regarding Medicaid refinancing, state funding, and how these issues affect local school-based Medicaid programs, please stay tuned to this thread.

As the 115th Congress kicks off, Republicans are working with President-elect Donald Trump on a plan to repeal the Affordable Care Act (ACA) and reform entitlement programs including Medicaid. The GOP wants to change Medicaid's financing structure to either a per capita cap or block grant. Either proposal will likely:

• Decrease total Medicaid funding available for school-based Medicaid service reimbursements,
• Limit healthcare coverage for students,
• Weaken districts' ability to utilize funding for critical health/wellness services and providing professionals in schools who can serve all students.
• Jeopardize districts' ability to comply with the Individuals with Disabilities Education Act (IDEA) since many use Medicaid reimbursements to pay for services provided by specialized instructional support personnel.

In response, ASBO International is working together with AASA-The School Superintendents Association to advocate against changing Medicaid's financing structure. We are distributing a short joint survey for school business officials, superintendents, and other school leaders to provide feedback about their school-based Medicaid programs and how a block grant or cap would affect their district. Please consider taking the survey and sharing it with your colleagues before it expires on January 9.

Last week, Republicans released a proposal to repeal and replace the Affordable Care Act (ACA) entitled the “American Health Care Act” (AHCA), which includes provisions to reform Medicaid. The bill went through a committee markup process and is expected to be reviewed by the House Budget Committee soon and introduced for a full chamber vote by the end of March. The Congressional Budget Office (CBO) provided a “score” for the AHCA this week, which outlines the proposal’s cost, how many Americans would gain/lose insurance coverage under the new law, and other statistics to inform elected officials about the healthcare bill. Below are highlights about the bill, if it were to pass and become law.

According to the CBO and various sources, the AHCA would...

• Reduce the deficit by $337 billion.
  
  
• Remove individual and employer mandates; reform health savings account (HSA) reimbursement and contribution limit requirements; and repeal most ACA taxes while retaining the Cadillac Tax (delayed until 2025).
  
  
• Cut Medicaid funding by $880 billion by rolling back state’s Medicaid expansion under the ACA and capping Medicaid funding based on a per-capita enrollment formula. It would freeze Medicaid’s expansion in 2020 and phase it out over time.
  • Find out how reduced Medicaid funding will affect school-based Medicaid services in this joint survey report with ASBO, AASA, and AESA.
    
    
• Reduce health insurance coverage for Americans overall. Uninsured rates are expected to spike in 2018 when the law first takes effect, and rise slowly through 2026 as the Medicaid expansion provision phases out.
  • Uninsured rate under ACA is estimated at a steady 10% whereas AHCA would spike up to 15% in 2018 and slowly rise to 18.6% by 2026.
    
    
• Replaces ACA subsidies with age-based tax credits to help individuals pay for coverage ranging from $2,000 to $4,000.
  
  
• Includes $100 billion in state grants over ten years to help states create high-risk pools, address the most expensive customers, and help stabilize the insurance market.

For more information, see this series of Washington Post infographics explaining what’s in and out with the healthcare proposal. Stay tuned to this thread for more updates about the ACHA and Medicaid reform, what school officials need to know, and how ASBO International is advocating on the issue.

A new ASBOUSA blog is available about Republican plans to reform and refinance the Medicaid program, which includes implications for state Medicaid funding and reimbursements to schools for school-based Medicaid services. The blog also highlights ASBO International's position and advocacy activities regarding refinancing the Medicaid program, resources to learn more about how Medicaid funding impacts states/schools, and information about the "Save Medicaid in the Schools Coalition (SMISC)," which we joined to strengthen our advocacy efforts.

For further alerts regarding Medicaid refinancing, state funding, and how these issues affect local school-based Medicaid programs, please stay tuned to this thread.

As the 115th Congress kicks off, Republicans are working with President-elect Donald Trump on a plan to repeal the Affordable Care Act (ACA) and reform entitlement programs including Medicaid. The GOP wants to change Medicaid's financing structure to either a per capita cap or block grant. Either proposal will likely:

• Decrease total Medicaid funding available for school-based Medicaid service reimbursements,
• Limit healthcare coverage for students,
• Weaken districts' ability to utilize funding for critical health/wellness services and providing professionals in schools who can serve all students.
• Jeopardize districts' ability to comply with the Individuals with Disabilities Education Act (IDEA) since many use Medicaid reimbursements to pay for services provided by specialized instructional support personnel.

In response, ASBO International is working together with AASA-The School Superintendents Association to advocate against changing Medicaid's financing structure. We are distributing a short joint survey for school business officials, superintendents, and other school leaders to provide feedback about their school-based Medicaid programs and how a block grant or cap would affect their district. Please consider taking the survey and sharing it with your colleagues before it expires on January 9.

Last week, Republicans released a proposal to repeal and replace the Affordable Care Act (ACA) entitled the “American Health Care Act” (AHCA), which includes provisions to reform Medicaid. The bill went through a committee markup process and is expected to be reviewed by the House Budget Committee soon and introduced for a full chamber vote by the end of March. The Congressional Budget Office (CBO) provided a “score” for the AHCA this week, which outlines the proposal’s cost, how many Americans would gain/lose insurance coverage under the new law, and other statistics to inform elected officials about the healthcare bill. Below are highlights about the bill, if it were to pass and become law.

According to the CBO and various sources, the AHCA would...

• Reduce the deficit by $337 billion.
  
  
• Remove individual and employer mandates; reform health savings account (HSA) reimbursement and contribution limit requirements; and repeal most ACA taxes while retaining the Cadillac Tax (delayed until 2025).
  
  
• Cut Medicaid funding by $880 billion by rolling back state’s Medicaid expansion under the ACA and capping Medicaid funding based on a per-capita enrollment formula. It would freeze Medicaid’s expansion in 2020 and phase it out over time.
  • Find out how reduced Medicaid funding will affect school-based Medicaid services in this joint survey report with ASBO, AASA, and AESA.
    
    
• Reduce health insurance coverage for Americans overall. Uninsured rates are expected to spike in 2018 when the law first takes effect, and rise slowly through 2026 as the Medicaid expansion provision phases out.
  • Uninsured rate under ACA is estimated at a steady 10% whereas AHCA would spike up to 15% in 2018 and slowly rise to 18.6% by 2026.
    
    
• Replaces ACA subsidies with age-based tax credits to help individuals pay for coverage ranging from $2,000 to $4,000.
  
  
• Includes $100 billion in state grants over ten years to help states create high-risk pools, address the most expensive customers, and help stabilize the insurance market.

For more information, see this series of Washington Post infographics explaining what’s in and out with the healthcare proposal. Stay tuned to this thread for more updates about the ACHA and Medicaid reform, what school officials need to know, and how ASBO International is advocating on the issue.

A new ASBOUSA blog is available about Republican plans to reform and refinance the Medicaid program, which includes implications for state Medicaid funding and reimbursements to schools for school-based Medicaid services. The blog also highlights ASBO International's position and advocacy activities regarding refinancing the Medicaid program, resources to learn more about how Medicaid funding impacts states/schools, and information about the "Save Medicaid in the Schools Coalition (SMISC)," which we joined to strengthen our advocacy efforts.

For further alerts regarding Medicaid refinancing, state funding, and how these issues affect local school-based Medicaid programs, please stay tuned to this thread.

As the 115th Congress kicks off, Republicans are working with President-elect Donald Trump on a plan to repeal the Affordable Care Act (ACA) and reform entitlement programs including Medicaid. The GOP wants to change Medicaid's financing structure to either a per capita cap or block grant. Either proposal will likely:

• Decrease total Medicaid funding available for school-based Medicaid service reimbursements,
• Limit healthcare coverage for students,
• Weaken districts' ability to utilize funding for critical health/wellness services and providing professionals in schools who can serve all students.
• Jeopardize districts' ability to comply with the Individuals with Disabilities Education Act (IDEA) since many use Medicaid reimbursements to pay for services provided by specialized instructional support personnel.

In response, ASBO International is working together with AASA-The School Superintendents Association to advocate against changing Medicaid's financing structure. We are distributing a short joint survey for school business officials, superintendents, and other school leaders to provide feedback about their school-based Medicaid programs and how a block grant or cap would affect their district. Please consider taking the survey and sharing it with your colleagues before it expires on January 9.

POLITICO reports that President Donald Trump has "failed to reach a deal with members of the House Freedom Caucus" on the latest version of the American Health Care Act (AHCA), the GOP's bill to replace the Affordable Care. The AHCA was scheduled for a vote in the House today, but, "with little margin for defections and eroding support from moderates," the House needed the House Freedom Caucus' support to ensure the bill would pass.

The latest version of the AHCA added in last-minute provisions that would have, among other things, allowed Medicaid dollars to flow to states either by a block grant or per-capita cap enrollment formula; ended Medicaid's ACA expansion by the end of 2017 instead of 2018; allowed states to impose work requirements on certain non-disabled adults as a condition of Medicaid coverage; delayed the ACA's "Cadillac Tax" until 2026 instead of 2025 and accelerate the repeal of all other ACA taxes from 2018 to 2017.

It remains to be seen whether the AHCA's vote will simply be delayed until Republican leaders can whip enough votes to ensure its passage, or if the bill will be scrapped altogether. Learn more about the AHCA here and find out how you can advocate with ASBO International on this issue in the meantime.

Last week, Republicans released a proposal to repeal and replace the Affordable Care Act (ACA) entitled the “American Health Care Act” (AHCA), which includes provisions to reform Medicaid. The bill went through a committee markup process and is expected to be reviewed by the House Budget Committee soon and introduced for a full chamber vote by the end of March. The Congressional Budget Office (CBO) provided a “score” for the AHCA this week, which outlines the proposal’s cost, how many Americans would gain/lose insurance coverage under the new law, and other statistics to inform elected officials about the healthcare bill. Below are highlights about the bill, if it were to pass and become law.

According to the CBO and various sources, the AHCA would...

• Reduce the deficit by $337 billion.
  
  
• Remove individual and employer mandates; reform health savings account (HSA) reimbursement and contribution limit requirements; and repeal most ACA taxes while retaining the Cadillac Tax (delayed until 2025).
  
  
• Cut Medicaid funding by $880 billion by rolling back state’s Medicaid expansion under the ACA and capping Medicaid funding based on a per-capita enrollment formula. It would freeze Medicaid’s expansion in 2020 and phase it out over time.
  • Find out how reduced Medicaid funding will affect school-based Medicaid services in this joint survey report with ASBO, AASA, and AESA.
    
    
• Reduce health insurance coverage for Americans overall. Uninsured rates are expected to spike in 2018 when the law first takes effect, and rise slowly through 2026 as the Medicaid expansion provision phases out.
  • Uninsured rate under ACA is estimated at a steady 10% whereas AHCA would spike up to 15% in 2018 and slowly rise to 18.6% by 2026.
    
    
• Replaces ACA subsidies with age-based tax credits to help individuals pay for coverage ranging from $2,000 to $4,000.
  
  
• Includes $100 billion in state grants over ten years to help states create high-risk pools, address the most expensive customers, and help stabilize the insurance market.

For more information, see this series of Washington Post infographics explaining what’s in and out with the healthcare proposal. Stay tuned to this thread for more updates about the ACHA and Medicaid reform, what school officials need to know, and how ASBO International is advocating on the issue.

A new ASBOUSA blog is available about Republican plans to reform and refinance the Medicaid program, which includes implications for state Medicaid funding and reimbursements to schools for school-based Medicaid services. The blog also highlights ASBO International's position and advocacy activities regarding refinancing the Medicaid program, resources to learn more about how Medicaid funding impacts states/schools, and information about the "Save Medicaid in the Schools Coalition (SMISC)," which we joined to strengthen our advocacy efforts.

For further alerts regarding Medicaid refinancing, state funding, and how these issues affect local school-based Medicaid programs, please stay tuned to this thread.

As the 115th Congress kicks off, Republicans are working with President-elect Donald Trump on a plan to repeal the Affordable Care Act (ACA) and reform entitlement programs including Medicaid. The GOP wants to change Medicaid's financing structure to either a per capita cap or block grant. Either proposal will likely:

• Decrease total Medicaid funding available for school-based Medicaid service reimbursements,
• Limit healthcare coverage for students,
• Weaken districts' ability to utilize funding for critical health/wellness services and providing professionals in schools who can serve all students.
• Jeopardize districts' ability to comply with the Individuals with Disabilities Education Act (IDEA) since many use Medicaid reimbursements to pay for services provided by specialized instructional support personnel.

In response, ASBO International is working together with AASA-The School Superintendents Association to advocate against changing Medicaid's financing structure. We are distributing a short joint survey for school business officials, superintendents, and other school leaders to provide feedback about their school-based Medicaid programs and how a block grant or cap would affect their district. Please consider taking the survey and sharing it with your colleagues before it expires on January 9.

After cancelling yesterday’s scheduled vote on the GOP bill to replace the Affordable Care Act, the “American Health Care Act” (AHCA), President Donald Trump is demanding House officials to vote on the proposal today. POLITICO reports, “If the bill fails, Trump is prepared to move on and leave Obamacare in place.” White House Budget Director Mick Mulvaney said the president was done with negotiation and “wanted an up-or-down vote now.”

Several last-minute changes were added to the AHCA that would affect Medicaid funding and gut essential health benefits in hopes of persuading far-right House Freedom Caucus members to support the bill. The Congressional Budget Office (CBO) released an updated score of the amended version, which POLITICO reports “would cost $186 billion more over 10 years compared to [the] initial version.” With the new numbers in mind, the AHCA is now expected to “reduce the deficit by $150 billion over 10 years, a decrease from the $337 billion initially projected” and would likely leave 24 million fewer Americans with insurance over the next decade. Find out what’s at stake for children’s healthcare services and benefits under the revised AHCA.

The House Rules Committee resumed its hearing on the bill at 7:00 a.m. (ET) this morning, and the House will likely vote on it today due to pressure from the White House. GOP leaders are hoping to have a final tally before 5:00 p.m. tonight, but as of now the vote count is still unclear. However, The Hill is keeping track of where elected officials stand on the AHCA here. See this alert to find out how you can advocate on this issue with ASBO International.

POLITICO reports that President Donald Trump has "failed to reach a deal with members of the House Freedom Caucus" on the latest version of the American Health Care Act (AHCA), the GOP's bill to replace the Affordable Care. The AHCA was scheduled for a vote in the House today, but, "with little margin for defections and eroding support from moderates," the House needed the House Freedom Caucus' support to ensure the bill would pass.

The latest version of the AHCA added in last-minute provisions that would have, among other things, allowed Medicaid dollars to flow to states either by a block grant or per-capita cap enrollment formula; ended Medicaid's ACA expansion by the end of 2017 instead of 2018; allowed states to impose work requirements on certain non-disabled adults as a condition of Medicaid coverage; delayed the ACA's "Cadillac Tax" until 2026 instead of 2025 and accelerate the repeal of all other ACA taxes from 2018 to 2017.

It remains to be seen whether the AHCA's vote will simply be delayed until Republican leaders can whip enough votes to ensure its passage, or if the bill will be scrapped altogether. Learn more about the AHCA here and find out how you can advocate with ASBO International on this issue in the meantime.

Last week, Republicans released a proposal to repeal and replace the Affordable Care Act (ACA) entitled the “American Health Care Act” (AHCA), which includes provisions to reform Medicaid. The bill went through a committee markup process and is expected to be reviewed by the House Budget Committee soon and introduced for a full chamber vote by the end of March. The Congressional Budget Office (CBO) provided a “score” for the AHCA this week, which outlines the proposal’s cost, how many Americans would gain/lose insurance coverage under the new law, and other statistics to inform elected officials about the healthcare bill. Below are highlights about the bill, if it were to pass and become law.

According to the CBO and various sources, the AHCA would...

• Reduce the deficit by $337 billion.
  
  
• Remove individual and employer mandates; reform health savings account (HSA) reimbursement and contribution limit requirements; and repeal most ACA taxes while retaining the Cadillac Tax (delayed until 2025).
  
  
• Cut Medicaid funding by $880 billion by rolling back state’s Medicaid expansion under the ACA and capping Medicaid funding based on a per-capita enrollment formula. It would freeze Medicaid’s expansion in 2020 and phase it out over time.
  • Find out how reduced Medicaid funding will affect school-based Medicaid services in this joint survey report with ASBO, AASA, and AESA.
    
    
• Reduce health insurance coverage for Americans overall. Uninsured rates are expected to spike in 2018 when the law first takes effect, and rise slowly through 2026 as the Medicaid expansion provision phases out.
  • Uninsured rate under ACA is estimated at a steady 10% whereas AHCA would spike up to 15% in 2018 and slowly rise to 18.6% by 2026.
    
    
• Replaces ACA subsidies with age-based tax credits to help individuals pay for coverage ranging from $2,000 to $4,000.
  
  
• Includes $100 billion in state grants over ten years to help states create high-risk pools, address the most expensive customers, and help stabilize the insurance market.

For more information, see this series of Washington Post infographics explaining what’s in and out with the healthcare proposal. Stay tuned to this thread for more updates about the ACHA and Medicaid reform, what school officials need to know, and how ASBO International is advocating on the issue.

A new ASBOUSA blog is available about Republican plans to reform and refinance the Medicaid program, which includes implications for state Medicaid funding and reimbursements to schools for school-based Medicaid services. The blog also highlights ASBO International's position and advocacy activities regarding refinancing the Medicaid program, resources to learn more about how Medicaid funding impacts states/schools, and information about the "Save Medicaid in the Schools Coalition (SMISC)," which we joined to strengthen our advocacy efforts.

For further alerts regarding Medicaid refinancing, state funding, and how these issues affect local school-based Medicaid programs, please stay tuned to this thread.

As the 115th Congress kicks off, Republicans are working with President-elect Donald Trump on a plan to repeal the Affordable Care Act (ACA) and reform entitlement programs including Medicaid. The GOP wants to change Medicaid's financing structure to either a per capita cap or block grant. Either proposal will likely:

• Decrease total Medicaid funding available for school-based Medicaid service reimbursements,
• Limit healthcare coverage for students,
• Weaken districts' ability to utilize funding for critical health/wellness services and providing professionals in schools who can serve all students.
• Jeopardize districts' ability to comply with the Individuals with Disabilities Education Act (IDEA) since many use Medicaid reimbursements to pay for services provided by specialized instructional support personnel.

In response, ASBO International is working together with AASA-The School Superintendents Association to advocate against changing Medicaid's financing structure. We are distributing a short joint survey for school business officials, superintendents, and other school leaders to provide feedback about their school-based Medicaid programs and how a block grant or cap would affect their district. Please consider taking the survey and sharing it with your colleagues before it expires on January 9.

As many of you are aware, House Speaker Paul Ryan (R-WI) pulled the Republican proposal to replace the Affordable Care Act (ACA) just before its vote in the House on Friday evening. POLITICO notes the bill “met sharp resistance from both ends of the Republican caucus, as hard-line conservatives in the House Freedom Caucus contended it failed to do away with Obamacare’s core components and moderates argued that its curbs on Medicaid could harm vulnerable constituents.” Speaker Ryan and President Trump were unable to reconcile competing pressures on the legislation, so the bill was withdrawn last minute.

The ACA will remain law for the time being, and now President Trump will move onto other priorities, including tax reform and infrastructure. Although Republicans may try to repeal the ACA another day, they are not expected to do so anytime soon. ASBO International would like to thank everyone who joined us in opposing the American Health Care Act (AHCA) bill and its provisions to cut Medicaid funding. This initiative would not have been successful without your help. We will continue working with the Save Medicaid in the Schools Coalition to increase public awareness about school-based Medicaid services and advocate to preserve Medicaid funding.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials. 
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district. 
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services. 
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials. 
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district. 
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services. 
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials. 
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district. 
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services. 
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

POLITICO and other media outlets are reporting that Senate Republicans will vote on their healthcare repeal plan by the end of June and will send the legislative text to the Congressional Budget Office (CBO) for scoring by the end of this week. The score will determine the proposal's costs, implications for insurance coverage, and other relevant items like the CBO did for the House healthcare proposal in May. The Senate's healthcare proposal has been kept relatively secret, but the Trump administration said that the Senate and House healthcare plans will have a lot of similarities, and Senate leadership said the bills will be about 80% the same.

ASBO International is continuing to work with the Save Medicaid in Schools Coalition to urge Congress to increase transparency with the Senate's healthcare proposal. We would prefer the bill be discussed openly and allow time for debate via public hearings with comments from policy experts. If the Senate repeal plan is essentially the same as the House's American Health Care Act (AHCA), this will be problematic as many citizens and advocacy groups (including ASBO International) have rejected that proposal, especially because of the AHCA's proposal to cut Medicaid funding. We believe it would be best if Congress would work across the aisle to improve our healthcare system in a bipartisan fashion.

If you're interested in joining ASBO International on this advocacy issue, consider contacting your elected officials and urge them to release the Senate healthcare proposal to the public. Also, state your opposition to Medicaid funding cuts and let your representatives know what these cuts would mean for your students.

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials. 
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district. 
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services. 
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

Good morning,

ASBO International has received new information about the Senate healthcare reform proposal from the Save Medicaid in the Schools Coalition, following the House proposal, HR 1628: The American Health Care Act (AHCA), passed in early May.

• Some sections of the Senate healthcare bill have already been scored by the Congressional Budget Office (CBO) and could be revealed later this week. Most of the Republican caucus has not seen the proposed language, which has caused significant concern about the lack of transparency of this process.
  
  
• June 26th is the expected date when the House bill (the AHCA) will be up for debate in the Senate, with a possible vote by as early as June 30th. We are encouraged to comment on the bill now, even before it has been made public.
  
  
• We should assume Medicaid funding cuts will be a part of any final package. Regardless if the amount is $500 billion or $800 billion, we are urged to continue opposing any funding cuts, period.

Please consider joining us and contact your elected officials about this issue. Express opposition to the lack of transparency on this bill, which has had no hearings on (and will likely be voted on with little to no notice to the public). Also, please share your comments on how school-based Medicaid programs would be impacted by the AHCA and Medicaid cuts. Attached are several resources to assist with your advocacy efforts, including:

• ASBO International's/AASA's School Medicaid Report and Medicaid advocacy toolkit,
• FY2015 data on school-Medicaid expenditures by state,
• Contact information for Senate staffers who focus on education issues,
• AASA blog with a Medicaid call script and talking points.

Thank you.

POLITICO and other media outlets are reporting that Senate Republicans will vote on their healthcare repeal plan by the end of June and will send the legislative text to the Congressional Budget Office (CBO) for scoring by the end of this week. The score will determine the proposal's costs, implications for insurance coverage, and other relevant items like the CBO did for the House healthcare proposal in May. The Senate's healthcare proposal has been kept relatively secret, but the Trump administration said that the Senate and House healthcare plans will have a lot of similarities, and Senate leadership said the bills will be about 80% the same.

ASBO International is continuing to work with the Save Medicaid in Schools Coalition to urge Congress to increase transparency with the Senate's healthcare proposal. We would prefer the bill be discussed openly and allow time for debate via public hearings with comments from policy experts. If the Senate repeal plan is essentially the same as the House's American Health Care Act (AHCA), this will be problematic as many citizens and advocacy groups (including ASBO International) have rejected that proposal, especially because of the AHCA's proposal to cut Medicaid funding. We believe it would be best if Congress would work across the aisle to improve our healthcare system in a bipartisan fashion.

If you're interested in joining ASBO International on this advocacy issue, consider contacting your elected officials and urge them to release the Senate healthcare proposal to the public. Also, state your opposition to Medicaid funding cuts and let your representatives know what these cuts would mean for your students.

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials. 
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district. 
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services. 
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

POLITICO reports that the Senate will release a discussion draft of its healthcare proposal to replace the Affordable Care Act (ACA) on Thursday and will "set the stage for a vote as soon as next week." Although senators are still negotiating major parts of the bill and details could change as Republicans whip votes to ensure the bill will pass, here's what we know so far:

GOP senators involved in crafting the draft bill are discussing:

• Eliminating several key provisions of the House bill (the American Health Care Act, AHCA), including $115 billion to help states stabilize their insurance markets and funding for ACA health insurance cost-sharing subsidies. (They'd tack these provisions onto a must-pass funding bill for the Children's Health Insurance Program [CHIP] later on instead).
  
  
• Phasing down funding for the ACA's Medicaid expansion over three years, beginning in 2020 or 2021, and shifting children covered under the expansion back into CHIP instead.
  
  
• Repealing all ACA taxes and making 1332 waiver rules less restrictive to give states more leeway to customize their Medicaid programs and health insurance markets.
  
  
• Lowering the annual increase in state Medicaid funding under a per-capita cap below the House's rate starting around 2025 (according to the Center on Budget and Policy Priorities). CBPP says this means "states would have to absorb even deeper cuts in federal Medicaid funding than under the House bill."

Please stay tuned for further updates on the Senate healthcare bill as we receive more information. In the meantime, consider contacting your senators and opposing any healthcare legislation that would cut Medicaid funding and jeopardize school-Medicaid programs. Feel free to use this toolkit to advocate on this issue.

Good morning,

ASBO International has received new information about the Senate healthcare reform proposal from the Save Medicaid in the Schools Coalition, following the House proposal, HR 1628: The American Health Care Act (AHCA), passed in early May.

• Some sections of the Senate healthcare bill have already been scored by the Congressional Budget Office (CBO) and could be revealed later this week. Most of the Republican caucus has not seen the proposed language, which has caused significant concern about the lack of transparency of this process.
  
  
• June 26th is the expected date when the House bill (the AHCA) will be up for debate in the Senate, with a possible vote by as early as June 30th. We are encouraged to comment on the bill now, even before it has been made public.
  
  
• We should assume Medicaid funding cuts will be a part of any final package. Regardless if the amount is $500 billion or $800 billion, we are urged to continue opposing any funding cuts, period.

Please consider joining us and contact your elected officials about this issue. Express opposition to the lack of transparency on this bill, which has had no hearings on (and will likely be voted on with little to no notice to the public). Also, please share your comments on how school-based Medicaid programs would be impacted by the AHCA and Medicaid cuts. Attached are several resources to assist with your advocacy efforts, including:

• ASBO International's/AASA's School Medicaid Report and Medicaid advocacy toolkit,
• FY2015 data on school-Medicaid expenditures by state,
• Contact information for Senate staffers who focus on education issues,
• AASA blog with a Medicaid call script and talking points.

Thank you.

POLITICO and other media outlets are reporting that Senate Republicans will vote on their healthcare repeal plan by the end of June and will send the legislative text to the Congressional Budget Office (CBO) for scoring by the end of this week. The score will determine the proposal's costs, implications for insurance coverage, and other relevant items like the CBO did for the House healthcare proposal in May. The Senate's healthcare proposal has been kept relatively secret, but the Trump administration said that the Senate and House healthcare plans will have a lot of similarities, and Senate leadership said the bills will be about 80% the same.

ASBO International is continuing to work with the Save Medicaid in Schools Coalition to urge Congress to increase transparency with the Senate's healthcare proposal. We would prefer the bill be discussed openly and allow time for debate via public hearings with comments from policy experts. If the Senate repeal plan is essentially the same as the House's American Health Care Act (AHCA), this will be problematic as many citizens and advocacy groups (including ASBO International) have rejected that proposal, especially because of the AHCA's proposal to cut Medicaid funding. We believe it would be best if Congress would work across the aisle to improve our healthcare system in a bipartisan fashion.

If you're interested in joining ASBO International on this advocacy issue, consider contacting your elected officials and urge them to release the Senate healthcare proposal to the public. Also, state your opposition to Medicaid funding cuts and let your representatives know what these cuts would mean for your students.

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials. 
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district. 
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services. 
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

Yesterday, Republican senators released their draft healthcare bill, the "Better Care Reconciliation Act of 2017" (BCRA) to replace the Affordable Care Act (ACA). See a bill summary here and here and a comparison between the House and Senate health care proposals here.

POLITICO reports the BCRA would eliminate the ACA's individual and employer mandates and "hundreds of millions of dollars in taxes" for the wealthy and the health industry. It would phase out the ACA's Medicaid expansion over three years beginning in 2021 and "make deep cuts" to Medicaid overall. The BCRA would retain subsidies to help low-income people buy insurance but only covers those who make "up to 350% of the federal poverty line-down from the 400% covered under Obamacare." States can opt out of some of the ACA's insurance requirements, but can't waive requirements that insurers accept everyone and charge the same rates (with few exceptions). However, the elderly may have to pay as much as five times more in insurance premiums than younger people for the same health plan.

The BCRA has yet to be scored by the Congressional Budget Office (CBO), which determines the proposal's cost, scope of insurance coverage, what will happen to Medicaid funding, etc. The CBO's score is expected early next week, and the Senate could vote on the BCRA as soon as next Thursday. President Donald Trump said he is "very supportive" of the proposal but shied away from a full endorsement, saying it would be "very good… [after] a little negotiation." Republican Senators Ted Cruz (TX), Ron Johnson (WI), Mike Lee (UT), and Rand Paul (KY) came out against the bill hours after its release because it wouldn't fully "repeal Obamacare and lower [Americans'] health care costs." And POLITICO says there is a "cadre of Republican moderates" who are still making up their mind. Democrats outright oppose the bill, and Senate Minority Leader Chuck Schumer (D-NY) called the bill "even meaner than the House version" for its deep Medicaid cuts, lack of protection for pre-existing conditions, and tax breaks for the wealthy.

The Save Medicaid in Schools Coalition (ASBO International is a member) also issued a statement on the BCRA, expressing disappointment that the Senate bill would end open funding for Medicaid as an entitlement program, which will jeopardize funding for school-based Medicaid programs. If you'd like to join ASBO International in opposing the BCRA and Medicaid cuts, find resources here and here to help with your advocacy efforts as you contact your senators.

POLITICO reports that the Senate will release a discussion draft of its healthcare proposal to replace the Affordable Care Act (ACA) on Thursday and will "set the stage for a vote as soon as next week." Although senators are still negotiating major parts of the bill and details could change as Republicans whip votes to ensure the bill will pass, here's what we know so far:

GOP senators involved in crafting the draft bill are discussing:

• Eliminating several key provisions of the House bill (the American Health Care Act, AHCA), including $115 billion to help states stabilize their insurance markets and funding for ACA health insurance cost-sharing subsidies. (They'd tack these provisions onto a must-pass funding bill for the Children's Health Insurance Program [CHIP] later on instead).
  
  
• Phasing down funding for the ACA's Medicaid expansion over three years, beginning in 2020 or 2021, and shifting children covered under the expansion back into CHIP instead.
  
  
• Repealing all ACA taxes and making 1332 waiver rules less restrictive to give states more leeway to customize their Medicaid programs and health insurance markets.
  
  
• Lowering the annual increase in state Medicaid funding under a per-capita cap below the House's rate starting around 2025 (according to the Center on Budget and Policy Priorities). CBPP says this means "states would have to absorb even deeper cuts in federal Medicaid funding than under the House bill."

Please stay tuned for further updates on the Senate healthcare bill as we receive more information. In the meantime, consider contacting your senators and opposing any healthcare legislation that would cut Medicaid funding and jeopardize school-Medicaid programs. Feel free to use this toolkit to advocate on this issue.

Good morning,

ASBO International has received new information about the Senate healthcare reform proposal from the Save Medicaid in the Schools Coalition, following the House proposal, HR 1628: The American Health Care Act (AHCA), passed in early May.

• Some sections of the Senate healthcare bill have already been scored by the Congressional Budget Office (CBO) and could be revealed later this week. Most of the Republican caucus has not seen the proposed language, which has caused significant concern about the lack of transparency of this process.
  
  
• June 26th is the expected date when the House bill (the AHCA) will be up for debate in the Senate, with a possible vote by as early as June 30th. We are encouraged to comment on the bill now, even before it has been made public.
  
  
• We should assume Medicaid funding cuts will be a part of any final package. Regardless if the amount is $500 billion or $800 billion, we are urged to continue opposing any funding cuts, period.

Please consider joining us and contact your elected officials about this issue. Express opposition to the lack of transparency on this bill, which has had no hearings on (and will likely be voted on with little to no notice to the public). Also, please share your comments on how school-based Medicaid programs would be impacted by the AHCA and Medicaid cuts. Attached are several resources to assist with your advocacy efforts, including:

• ASBO International's/AASA's School Medicaid Report and Medicaid advocacy toolkit,
• FY2015 data on school-Medicaid expenditures by state,
• Contact information for Senate staffers who focus on education issues,
• AASA blog with a Medicaid call script and talking points.

Thank you.

POLITICO and other media outlets are reporting that Senate Republicans will vote on their healthcare repeal plan by the end of June and will send the legislative text to the Congressional Budget Office (CBO) for scoring by the end of this week. The score will determine the proposal's costs, implications for insurance coverage, and other relevant items like the CBO did for the House healthcare proposal in May. The Senate's healthcare proposal has been kept relatively secret, but the Trump administration said that the Senate and House healthcare plans will have a lot of similarities, and Senate leadership said the bills will be about 80% the same.

ASBO International is continuing to work with the Save Medicaid in Schools Coalition to urge Congress to increase transparency with the Senate's healthcare proposal. We would prefer the bill be discussed openly and allow time for debate via public hearings with comments from policy experts. If the Senate repeal plan is essentially the same as the House's American Health Care Act (AHCA), this will be problematic as many citizens and advocacy groups (including ASBO International) have rejected that proposal, especially because of the AHCA's proposal to cut Medicaid funding. We believe it would be best if Congress would work across the aisle to improve our healthcare system in a bipartisan fashion.

If you're interested in joining ASBO International on this advocacy issue, consider contacting your elected officials and urge them to release the Senate healthcare proposal to the public. Also, state your opposition to Medicaid funding cuts and let your representatives know what these cuts would mean for your students.

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials. 
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district. 
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services. 
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

Thank you to everyone who advocated with ASBO International against the Senate Republican health care bill, the "Better Care Reconciliation Act (BCRA)," which would cut Medicaid funding by $772 billion over ten years and jeopardize school-Medicaid programs. The Senate has delayed the vote on the bill until after Congress' July 4 recess since there is insufficient support for BCRA in its current form. Senators will rewrite the bill over the recess, get a new score assessing the cost/impact of the legislation, and vote after they return to Washington, D.C. on July 10.

Consequently, ASBO International and the Save Medicaid in Schools Coalition are keeping the pressure on senators and sent a letter urging them to oppose BCRA or any proposal that would cut Medicaid funding and harm students. We will continue advocating on this issue and invite you to join us. Please find several resources below to assist with your advocacy efforts, and consider meeting with your officials while they are at home, working out of their local offices.

• "Ten Ways the Senate's BCRA Harms Children and Offers Worse Care," talking points created by the Children's Defense Fund.
• "Cutting Medicaid: A Prescription to Hurt the Neediest Kids" press release and survey report published by ASBO International and AASA, The School Superintendents Association.
• "If You Haven't Taken Action to Protect Medicaid in Schools, You're Missing a Major Opportunity" blog with advocacy resources by AASA.

Please stay tuned to this thread for more information as we receive further updates.

Yesterday, Republican senators released their draft healthcare bill, the "Better Care Reconciliation Act of 2017" (BCRA) to replace the Affordable Care Act (ACA). See a bill summary here and here and a comparison between the House and Senate health care proposals here.

POLITICO reports the BCRA would eliminate the ACA's individual and employer mandates and "hundreds of millions of dollars in taxes" for the wealthy and the health industry. It would phase out the ACA's Medicaid expansion over three years beginning in 2021 and "make deep cuts" to Medicaid overall. The BCRA would retain subsidies to help low-income people buy insurance but only covers those who make "up to 350% of the federal poverty line-down from the 400% covered under Obamacare." States can opt out of some of the ACA's insurance requirements, but can't waive requirements that insurers accept everyone and charge the same rates (with few exceptions). However, the elderly may have to pay as much as five times more in insurance premiums than younger people for the same health plan.

The BCRA has yet to be scored by the Congressional Budget Office (CBO), which determines the proposal's cost, scope of insurance coverage, what will happen to Medicaid funding, etc. The CBO's score is expected early next week, and the Senate could vote on the BCRA as soon as next Thursday. President Donald Trump said he is "very supportive" of the proposal but shied away from a full endorsement, saying it would be "very good… [after] a little negotiation." Republican Senators Ted Cruz (TX), Ron Johnson (WI), Mike Lee (UT), and Rand Paul (KY) came out against the bill hours after its release because it wouldn't fully "repeal Obamacare and lower [Americans'] health care costs." And POLITICO says there is a "cadre of Republican moderates" who are still making up their mind. Democrats outright oppose the bill, and Senate Minority Leader Chuck Schumer (D-NY) called the bill "even meaner than the House version" for its deep Medicaid cuts, lack of protection for pre-existing conditions, and tax breaks for the wealthy.

The Save Medicaid in Schools Coalition (ASBO International is a member) also issued a statement on the BCRA, expressing disappointment that the Senate bill would end open funding for Medicaid as an entitlement program, which will jeopardize funding for school-based Medicaid programs. If you'd like to join ASBO International in opposing the BCRA and Medicaid cuts, find resources here and here to help with your advocacy efforts as you contact your senators.

POLITICO reports that the Senate will release a discussion draft of its healthcare proposal to replace the Affordable Care Act (ACA) on Thursday and will "set the stage for a vote as soon as next week." Although senators are still negotiating major parts of the bill and details could change as Republicans whip votes to ensure the bill will pass, here's what we know so far:

GOP senators involved in crafting the draft bill are discussing:

• Eliminating several key provisions of the House bill (the American Health Care Act, AHCA), including $115 billion to help states stabilize their insurance markets and funding for ACA health insurance cost-sharing subsidies. (They'd tack these provisions onto a must-pass funding bill for the Children's Health Insurance Program [CHIP] later on instead).
  
  
• Phasing down funding for the ACA's Medicaid expansion over three years, beginning in 2020 or 2021, and shifting children covered under the expansion back into CHIP instead.
  
  
• Repealing all ACA taxes and making 1332 waiver rules less restrictive to give states more leeway to customize their Medicaid programs and health insurance markets.
  
  
• Lowering the annual increase in state Medicaid funding under a per-capita cap below the House's rate starting around 2025 (according to the Center on Budget and Policy Priorities). CBPP says this means "states would have to absorb even deeper cuts in federal Medicaid funding than under the House bill."

Please stay tuned for further updates on the Senate healthcare bill as we receive more information. In the meantime, consider contacting your senators and opposing any healthcare legislation that would cut Medicaid funding and jeopardize school-Medicaid programs. Feel free to use this toolkit to advocate on this issue.

Good morning,

ASBO International has received new information about the Senate healthcare reform proposal from the Save Medicaid in the Schools Coalition, following the House proposal, HR 1628: The American Health Care Act (AHCA), passed in early May.

• Some sections of the Senate healthcare bill have already been scored by the Congressional Budget Office (CBO) and could be revealed later this week. Most of the Republican caucus has not seen the proposed language, which has caused significant concern about the lack of transparency of this process.
  
  
• June 26th is the expected date when the House bill (the AHCA) will be up for debate in the Senate, with a possible vote by as early as June 30th. We are encouraged to comment on the bill now, even before it has been made public.
  
  
• We should assume Medicaid funding cuts will be a part of any final package. Regardless if the amount is $500 billion or $800 billion, we are urged to continue opposing any funding cuts, period.

Please consider joining us and contact your elected officials about this issue. Express opposition to the lack of transparency on this bill, which has had no hearings on (and will likely be voted on with little to no notice to the public). Also, please share your comments on how school-based Medicaid programs would be impacted by the AHCA and Medicaid cuts. Attached are several resources to assist with your advocacy efforts, including:

• ASBO International's/AASA's School Medicaid Report and Medicaid advocacy toolkit,
• FY2015 data on school-Medicaid expenditures by state,
• Contact information for Senate staffers who focus on education issues,
• AASA blog with a Medicaid call script and talking points.

Thank you.

POLITICO and other media outlets are reporting that Senate Republicans will vote on their healthcare repeal plan by the end of June and will send the legislative text to the Congressional Budget Office (CBO) for scoring by the end of this week. The score will determine the proposal's costs, implications for insurance coverage, and other relevant items like the CBO did for the House healthcare proposal in May. The Senate's healthcare proposal has been kept relatively secret, but the Trump administration said that the Senate and House healthcare plans will have a lot of similarities, and Senate leadership said the bills will be about 80% the same.

ASBO International is continuing to work with the Save Medicaid in Schools Coalition to urge Congress to increase transparency with the Senate's healthcare proposal. We would prefer the bill be discussed openly and allow time for debate via public hearings with comments from policy experts. If the Senate repeal plan is essentially the same as the House's American Health Care Act (AHCA), this will be problematic as many citizens and advocacy groups (including ASBO International) have rejected that proposal, especially because of the AHCA's proposal to cut Medicaid funding. We believe it would be best if Congress would work across the aisle to improve our healthcare system in a bipartisan fashion.

If you're interested in joining ASBO International on this advocacy issue, consider contacting your elected officials and urge them to release the Senate healthcare proposal to the public. Also, state your opposition to Medicaid funding cuts and let your representatives know what these cuts would mean for your students.

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials. 
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district. 
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services. 
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

By now, many of you have likely heard that the vote on the Senate Republican health care bill, the revised "Better Care Reconciliation Act (BCRA)," was delayed after Sen. Majority Leader Mitch McConnell (R-KY) realized there were insufficient votes to move forward. Since Monday, more Republican Senators have come out against BCRA, citing concerns with the bill's provisions to cut Medicaid in particular. This is a direct result of your advocacy efforts to preserve Medicaid funding.

Thank you for continuing to advocate with ASBO International against BCRA and Medicaid funding cuts. Based on feedback we have heard from Hill officials and staff during the 2017 Legislative Advocacy Conference last week, we can confirm that your representatives are hearing you loud and clear. Officials are beginning to understand the impact that Medicaid cuts will have on states, schools, and students, so we encourage you to continue educating them about this issue.

It is premature to say that BCRA has been stopped completely though, as POLITICO reported this morning that the President "has invited all 52 Republic senators for lunch today as part of a last ditch effort to save the GOP's fading health care push." Sen. McConnell will hold a vote to open debate on health care next week, however many are expecting it to fail. Nevertheless, a public vote would provide officials a chance to state their position on BCRA for the record. Meanwhile, other senators are moving to consider bipartisan avenues for health care reform, but nothing concrete has emerged yet. Please stay tuned to this thread for more updates about the GOP's health care reform strategy as we learn more.

Thank you to everyone who advocated with ASBO International against the Senate Republican health care bill, the "Better Care Reconciliation Act (BCRA)," which would cut Medicaid funding by $772 billion over ten years and jeopardize school-Medicaid programs. The Senate has delayed the vote on the bill until after Congress' July 4 recess since there is insufficient support for BCRA in its current form. Senators will rewrite the bill over the recess, get a new score assessing the cost/impact of the legislation, and vote after they return to Washington, D.C. on July 10.

Consequently, ASBO International and the Save Medicaid in Schools Coalition are keeping the pressure on senators and sent a letter urging them to oppose BCRA or any proposal that would cut Medicaid funding and harm students. We will continue advocating on this issue and invite you to join us. Please find several resources below to assist with your advocacy efforts, and consider meeting with your officials while they are at home, working out of their local offices.

• "Ten Ways the Senate's BCRA Harms Children and Offers Worse Care," talking points created by the Children's Defense Fund.
• "Cutting Medicaid: A Prescription to Hurt the Neediest Kids" press release and survey report published by ASBO International and AASA, The School Superintendents Association.
• "If You Haven't Taken Action to Protect Medicaid in Schools, You're Missing a Major Opportunity" blog with advocacy resources by AASA.

Please stay tuned to this thread for more information as we receive further updates.

Yesterday, Republican senators released their draft healthcare bill, the "Better Care Reconciliation Act of 2017" (BCRA) to replace the Affordable Care Act (ACA). See a bill summary here and here and a comparison between the House and Senate health care proposals here.

POLITICO reports the BCRA would eliminate the ACA's individual and employer mandates and "hundreds of millions of dollars in taxes" for the wealthy and the health industry. It would phase out the ACA's Medicaid expansion over three years beginning in 2021 and "make deep cuts" to Medicaid overall. The BCRA would retain subsidies to help low-income people buy insurance but only covers those who make "up to 350% of the federal poverty line-down from the 400% covered under Obamacare." States can opt out of some of the ACA's insurance requirements, but can't waive requirements that insurers accept everyone and charge the same rates (with few exceptions). However, the elderly may have to pay as much as five times more in insurance premiums than younger people for the same health plan.

The BCRA has yet to be scored by the Congressional Budget Office (CBO), which determines the proposal's cost, scope of insurance coverage, what will happen to Medicaid funding, etc. The CBO's score is expected early next week, and the Senate could vote on the BCRA as soon as next Thursday. President Donald Trump said he is "very supportive" of the proposal but shied away from a full endorsement, saying it would be "very good… [after] a little negotiation." Republican Senators Ted Cruz (TX), Ron Johnson (WI), Mike Lee (UT), and Rand Paul (KY) came out against the bill hours after its release because it wouldn't fully "repeal Obamacare and lower [Americans'] health care costs." And POLITICO says there is a "cadre of Republican moderates" who are still making up their mind. Democrats outright oppose the bill, and Senate Minority Leader Chuck Schumer (D-NY) called the bill "even meaner than the House version" for its deep Medicaid cuts, lack of protection for pre-existing conditions, and tax breaks for the wealthy.

The Save Medicaid in Schools Coalition (ASBO International is a member) also issued a statement on the BCRA, expressing disappointment that the Senate bill would end open funding for Medicaid as an entitlement program, which will jeopardize funding for school-based Medicaid programs. If you'd like to join ASBO International in opposing the BCRA and Medicaid cuts, find resources here and here to help with your advocacy efforts as you contact your senators.

POLITICO reports that the Senate will release a discussion draft of its healthcare proposal to replace the Affordable Care Act (ACA) on Thursday and will "set the stage for a vote as soon as next week." Although senators are still negotiating major parts of the bill and details could change as Republicans whip votes to ensure the bill will pass, here's what we know so far:

GOP senators involved in crafting the draft bill are discussing:

• Eliminating several key provisions of the House bill (the American Health Care Act, AHCA), including $115 billion to help states stabilize their insurance markets and funding for ACA health insurance cost-sharing subsidies. (They'd tack these provisions onto a must-pass funding bill for the Children's Health Insurance Program [CHIP] later on instead).
  
  
• Phasing down funding for the ACA's Medicaid expansion over three years, beginning in 2020 or 2021, and shifting children covered under the expansion back into CHIP instead.
  
  
• Repealing all ACA taxes and making 1332 waiver rules less restrictive to give states more leeway to customize their Medicaid programs and health insurance markets.
  
  
• Lowering the annual increase in state Medicaid funding under a per-capita cap below the House's rate starting around 2025 (according to the Center on Budget and Policy Priorities). CBPP says this means "states would have to absorb even deeper cuts in federal Medicaid funding than under the House bill."

Please stay tuned for further updates on the Senate healthcare bill as we receive more information. In the meantime, consider contacting your senators and opposing any healthcare legislation that would cut Medicaid funding and jeopardize school-Medicaid programs. Feel free to use this toolkit to advocate on this issue.

Good morning,

ASBO International has received new information about the Senate healthcare reform proposal from the Save Medicaid in the Schools Coalition, following the House proposal, HR 1628: The American Health Care Act (AHCA), passed in early May.

• Some sections of the Senate healthcare bill have already been scored by the Congressional Budget Office (CBO) and could be revealed later this week. Most of the Republican caucus has not seen the proposed language, which has caused significant concern about the lack of transparency of this process.
  
  
• June 26th is the expected date when the House bill (the AHCA) will be up for debate in the Senate, with a possible vote by as early as June 30th. We are encouraged to comment on the bill now, even before it has been made public.
  
  
• We should assume Medicaid funding cuts will be a part of any final package. Regardless if the amount is $500 billion or $800 billion, we are urged to continue opposing any funding cuts, period.

Please consider joining us and contact your elected officials about this issue. Express opposition to the lack of transparency on this bill, which has had no hearings on (and will likely be voted on with little to no notice to the public). Also, please share your comments on how school-based Medicaid programs would be impacted by the AHCA and Medicaid cuts. Attached are several resources to assist with your advocacy efforts, including:

• ASBO International's/AASA's School Medicaid Report and Medicaid advocacy toolkit,
• FY2015 data on school-Medicaid expenditures by state,
• Contact information for Senate staffers who focus on education issues,
• AASA blog with a Medicaid call script and talking points.

Thank you.

POLITICO and other media outlets are reporting that Senate Republicans will vote on their healthcare repeal plan by the end of June and will send the legislative text to the Congressional Budget Office (CBO) for scoring by the end of this week. The score will determine the proposal's costs, implications for insurance coverage, and other relevant items like the CBO did for the House healthcare proposal in May. The Senate's healthcare proposal has been kept relatively secret, but the Trump administration said that the Senate and House healthcare plans will have a lot of similarities, and Senate leadership said the bills will be about 80% the same.

ASBO International is continuing to work with the Save Medicaid in Schools Coalition to urge Congress to increase transparency with the Senate's healthcare proposal. We would prefer the bill be discussed openly and allow time for debate via public hearings with comments from policy experts. If the Senate repeal plan is essentially the same as the House's American Health Care Act (AHCA), this will be problematic as many citizens and advocacy groups (including ASBO International) have rejected that proposal, especially because of the AHCA's proposal to cut Medicaid funding. We believe it would be best if Congress would work across the aisle to improve our healthcare system in a bipartisan fashion.

If you're interested in joining ASBO International on this advocacy issue, consider contacting your elected officials and urge them to release the Senate healthcare proposal to the public. Also, state your opposition to Medicaid funding cuts and let your representatives know what these cuts would mean for your students.

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials. 
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district. 
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services. 
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

The Senate is expected to vote on a motion to proceed debate on the GOP's healthcare plan today at 2:15 EST. There are few details known about the specific plan, whether it's a full repeal-and-replace or a repeal-only plan. The first option would be the Better Care Reconciliation Act (BCRA) and the second would likely be a plan that was passed by Congress in 2015 but vetoed by President Barack Obama at the time. (Learn more here).

If the motion-to-proceed vote is successful, then the Senate can start debate immediately or start tomorrow morning. There would be 20 hours of debate and opportunity to vote on bill amendments, then Sen. Majority Leader Mitch McConnell will likely substitute something at the last minute for a final vote (without time for the Congressional Budget Office to provide an updated analysis on the bill's impact on the public and budget). Sens. Paul (R-KY), Murkowski (R-AK), Capito (R-WV), Heller, (R-NV), Moran (R-KS), Portman (R-OH), and Lee (R-UT),are still unknown votes, but nevertheless it is expected to be a close one.

In response, ASBO International and the Save Medicaid in Schools Coalition sent another letter to Senate leaders this morning urging them to oppose any plan that would cut Medicaid funding and jeopardize school-based Medicaid programs and services. Please feel free to join us in this effort to oppose Medicaid cuts by contacting your senators and using these resources to support your advocacy efforts.

By now, many of you have likely heard that the vote on the Senate Republican health care bill, the revised "Better Care Reconciliation Act (BCRA)," was delayed after Sen. Majority Leader Mitch McConnell (R-KY) realized there were insufficient votes to move forward. Since Monday, more Republican Senators have come out against BCRA, citing concerns with the bill's provisions to cut Medicaid in particular. This is a direct result of your advocacy efforts to preserve Medicaid funding.

Thank you for continuing to advocate with ASBO International against BCRA and Medicaid funding cuts. Based on feedback we have heard from Hill officials and staff during the 2017 Legislative Advocacy Conference last week, we can confirm that your representatives are hearing you loud and clear. Officials are beginning to understand the impact that Medicaid cuts will have on states, schools, and students, so we encourage you to continue educating them about this issue.

It is premature to say that BCRA has been stopped completely though, as POLITICO reported this morning that the President "has invited all 52 Republic senators for lunch today as part of a last ditch effort to save the GOP's fading health care push." Sen. McConnell will hold a vote to open debate on health care next week, however many are expecting it to fail. Nevertheless, a public vote would provide officials a chance to state their position on BCRA for the record. Meanwhile, other senators are moving to consider bipartisan avenues for health care reform, but nothing concrete has emerged yet. Please stay tuned to this thread for more updates about the GOP's health care reform strategy as we learn more.

Thank you to everyone who advocated with ASBO International against the Senate Republican health care bill, the "Better Care Reconciliation Act (BCRA)," which would cut Medicaid funding by $772 billion over ten years and jeopardize school-Medicaid programs. The Senate has delayed the vote on the bill until after Congress' July 4 recess since there is insufficient support for BCRA in its current form. Senators will rewrite the bill over the recess, get a new score assessing the cost/impact of the legislation, and vote after they return to Washington, D.C. on July 10.

Consequently, ASBO International and the Save Medicaid in Schools Coalition are keeping the pressure on senators and sent a letter urging them to oppose BCRA or any proposal that would cut Medicaid funding and harm students. We will continue advocating on this issue and invite you to join us. Please find several resources below to assist with your advocacy efforts, and consider meeting with your officials while they are at home, working out of their local offices.

• "Ten Ways the Senate's BCRA Harms Children and Offers Worse Care," talking points created by the Children's Defense Fund.
• "Cutting Medicaid: A Prescription to Hurt the Neediest Kids" press release and survey report published by ASBO International and AASA, The School Superintendents Association.
• "If You Haven't Taken Action to Protect Medicaid in Schools, You're Missing a Major Opportunity" blog with advocacy resources by AASA.

Please stay tuned to this thread for more information as we receive further updates.

Yesterday, Republican senators released their draft healthcare bill, the "Better Care Reconciliation Act of 2017" (BCRA) to replace the Affordable Care Act (ACA). See a bill summary here and here and a comparison between the House and Senate health care proposals here.

POLITICO reports the BCRA would eliminate the ACA's individual and employer mandates and "hundreds of millions of dollars in taxes" for the wealthy and the health industry. It would phase out the ACA's Medicaid expansion over three years beginning in 2021 and "make deep cuts" to Medicaid overall. The BCRA would retain subsidies to help low-income people buy insurance but only covers those who make "up to 350% of the federal poverty line-down from the 400% covered under Obamacare." States can opt out of some of the ACA's insurance requirements, but can't waive requirements that insurers accept everyone and charge the same rates (with few exceptions). However, the elderly may have to pay as much as five times more in insurance premiums than younger people for the same health plan.

The BCRA has yet to be scored by the Congressional Budget Office (CBO), which determines the proposal's cost, scope of insurance coverage, what will happen to Medicaid funding, etc. The CBO's score is expected early next week, and the Senate could vote on the BCRA as soon as next Thursday. President Donald Trump said he is "very supportive" of the proposal but shied away from a full endorsement, saying it would be "very good… [after] a little negotiation." Republican Senators Ted Cruz (TX), Ron Johnson (WI), Mike Lee (UT), and Rand Paul (KY) came out against the bill hours after its release because it wouldn't fully "repeal Obamacare and lower [Americans'] health care costs." And POLITICO says there is a "cadre of Republican moderates" who are still making up their mind. Democrats outright oppose the bill, and Senate Minority Leader Chuck Schumer (D-NY) called the bill "even meaner than the House version" for its deep Medicaid cuts, lack of protection for pre-existing conditions, and tax breaks for the wealthy.

The Save Medicaid in Schools Coalition (ASBO International is a member) also issued a statement on the BCRA, expressing disappointment that the Senate bill would end open funding for Medicaid as an entitlement program, which will jeopardize funding for school-based Medicaid programs. If you'd like to join ASBO International in opposing the BCRA and Medicaid cuts, find resources here and here to help with your advocacy efforts as you contact your senators.

POLITICO reports that the Senate will release a discussion draft of its healthcare proposal to replace the Affordable Care Act (ACA) on Thursday and will "set the stage for a vote as soon as next week." Although senators are still negotiating major parts of the bill and details could change as Republicans whip votes to ensure the bill will pass, here's what we know so far:

GOP senators involved in crafting the draft bill are discussing:

• Eliminating several key provisions of the House bill (the American Health Care Act, AHCA), including $115 billion to help states stabilize their insurance markets and funding for ACA health insurance cost-sharing subsidies. (They'd tack these provisions onto a must-pass funding bill for the Children's Health Insurance Program [CHIP] later on instead).
  
  
• Phasing down funding for the ACA's Medicaid expansion over three years, beginning in 2020 or 2021, and shifting children covered under the expansion back into CHIP instead.
  
  
• Repealing all ACA taxes and making 1332 waiver rules less restrictive to give states more leeway to customize their Medicaid programs and health insurance markets.
  
  
• Lowering the annual increase in state Medicaid funding under a per-capita cap below the House's rate starting around 2025 (according to the Center on Budget and Policy Priorities). CBPP says this means "states would have to absorb even deeper cuts in federal Medicaid funding than under the House bill."

Please stay tuned for further updates on the Senate healthcare bill as we receive more information. In the meantime, consider contacting your senators and opposing any healthcare legislation that would cut Medicaid funding and jeopardize school-Medicaid programs. Feel free to use this toolkit to advocate on this issue.

Good morning,

ASBO International has received new information about the Senate healthcare reform proposal from the Save Medicaid in the Schools Coalition, following the House proposal, HR 1628: The American Health Care Act (AHCA), passed in early May.

• Some sections of the Senate healthcare bill have already been scored by the Congressional Budget Office (CBO) and could be revealed later this week. Most of the Republican caucus has not seen the proposed language, which has caused significant concern about the lack of transparency of this process.
  
  
• June 26th is the expected date when the House bill (the AHCA) will be up for debate in the Senate, with a possible vote by as early as June 30th. We are encouraged to comment on the bill now, even before it has been made public.
  
  
• We should assume Medicaid funding cuts will be a part of any final package. Regardless if the amount is $500 billion or $800 billion, we are urged to continue opposing any funding cuts, period.

Please consider joining us and contact your elected officials about this issue. Express opposition to the lack of transparency on this bill, which has had no hearings on (and will likely be voted on with little to no notice to the public). Also, please share your comments on how school-based Medicaid programs would be impacted by the AHCA and Medicaid cuts. Attached are several resources to assist with your advocacy efforts, including:

• ASBO International's/AASA's School Medicaid Report and Medicaid advocacy toolkit,
• FY2015 data on school-Medicaid expenditures by state,
• Contact information for Senate staffers who focus on education issues,
• AASA blog with a Medicaid call script and talking points.

Thank you.

POLITICO and other media outlets are reporting that Senate Republicans will vote on their healthcare repeal plan by the end of June and will send the legislative text to the Congressional Budget Office (CBO) for scoring by the end of this week. The score will determine the proposal's costs, implications for insurance coverage, and other relevant items like the CBO did for the House healthcare proposal in May. The Senate's healthcare proposal has been kept relatively secret, but the Trump administration said that the Senate and House healthcare plans will have a lot of similarities, and Senate leadership said the bills will be about 80% the same.

ASBO International is continuing to work with the Save Medicaid in Schools Coalition to urge Congress to increase transparency with the Senate's healthcare proposal. We would prefer the bill be discussed openly and allow time for debate via public hearings with comments from policy experts. If the Senate repeal plan is essentially the same as the House's American Health Care Act (AHCA), this will be problematic as many citizens and advocacy groups (including ASBO International) have rejected that proposal, especially because of the AHCA's proposal to cut Medicaid funding. We believe it would be best if Congress would work across the aisle to improve our healthcare system in a bipartisan fashion.

If you're interested in joining ASBO International on this advocacy issue, consider contacting your elected officials and urge them to release the Senate healthcare proposal to the public. Also, state your opposition to Medicaid funding cuts and let your representatives know what these cuts would mean for your students.

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials. 
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district. 
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services. 
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

The Senate is expected to vote on a motion to proceed debate on the GOP's healthcare plan today at 2:15 EST. There are few details known about the specific plan, whether it's a full repeal-and-replace or a repeal-only plan. The first option would be the Better Care Reconciliation Act (BCRA) and the second would likely be a plan that was passed by Congress in 2015 but vetoed by President Barack Obama at the time. (Learn more here).

If the motion-to-proceed vote is successful, then the Senate can start debate immediately or start tomorrow morning. There would be 20 hours of debate and opportunity to vote on bill amendments, then Sen. Majority Leader Mitch McConnell will likely substitute something at the last minute for a final vote (without time for the Congressional Budget Office to provide an updated analysis on the bill's impact on the public and budget). Sens. Paul (R-KY), Murkowski (R-AK), Capito (R-WV), Heller, (R-NV), Moran (R-KS), Portman (R-OH), and Lee (R-UT),are still unknown votes, but nevertheless it is expected to be a close one.

In response, ASBO International and the Save Medicaid in Schools Coalition sent another letter to Senate leaders this morning urging them to oppose any plan that would cut Medicaid funding and jeopardize school-based Medicaid programs and services. Please feel free to join us in this effort to oppose Medicaid cuts by contacting your senators and using these resources to support your advocacy efforts.

By now, many of you have likely heard that the vote on the Senate Republican health care bill, the revised "Better Care Reconciliation Act (BCRA)," was delayed after Sen. Majority Leader Mitch McConnell (R-KY) realized there were insufficient votes to move forward. Since Monday, more Republican Senators have come out against BCRA, citing concerns with the bill's provisions to cut Medicaid in particular. This is a direct result of your advocacy efforts to preserve Medicaid funding.

Thank you for continuing to advocate with ASBO International against BCRA and Medicaid funding cuts. Based on feedback we have heard from Hill officials and staff during the 2017 Legislative Advocacy Conference last week, we can confirm that your representatives are hearing you loud and clear. Officials are beginning to understand the impact that Medicaid cuts will have on states, schools, and students, so we encourage you to continue educating them about this issue.

It is premature to say that BCRA has been stopped completely though, as POLITICO reported this morning that the President "has invited all 52 Republic senators for lunch today as part of a last ditch effort to save the GOP's fading health care push." Sen. McConnell will hold a vote to open debate on health care next week, however many are expecting it to fail. Nevertheless, a public vote would provide officials a chance to state their position on BCRA for the record. Meanwhile, other senators are moving to consider bipartisan avenues for health care reform, but nothing concrete has emerged yet. Please stay tuned to this thread for more updates about the GOP's health care reform strategy as we learn more.

Thank you to everyone who advocated with ASBO International against the Senate Republican health care bill, the "Better Care Reconciliation Act (BCRA)," which would cut Medicaid funding by $772 billion over ten years and jeopardize school-Medicaid programs. The Senate has delayed the vote on the bill until after Congress' July 4 recess since there is insufficient support for BCRA in its current form. Senators will rewrite the bill over the recess, get a new score assessing the cost/impact of the legislation, and vote after they return to Washington, D.C. on July 10.

Consequently, ASBO International and the Save Medicaid in Schools Coalition are keeping the pressure on senators and sent a letter urging them to oppose BCRA or any proposal that would cut Medicaid funding and harm students. We will continue advocating on this issue and invite you to join us. Please find several resources below to assist with your advocacy efforts, and consider meeting with your officials while they are at home, working out of their local offices.

• "Ten Ways the Senate's BCRA Harms Children and Offers Worse Care," talking points created by the Children's Defense Fund.
• "Cutting Medicaid: A Prescription to Hurt the Neediest Kids" press release and survey report published by ASBO International and AASA, The School Superintendents Association.
• "If You Haven't Taken Action to Protect Medicaid in Schools, You're Missing a Major Opportunity" blog with advocacy resources by AASA.

Please stay tuned to this thread for more information as we receive further updates.

Yesterday, Republican senators released their draft healthcare bill, the "Better Care Reconciliation Act of 2017" (BCRA) to replace the Affordable Care Act (ACA). See a bill summary here and here and a comparison between the House and Senate health care proposals here.

POLITICO reports the BCRA would eliminate the ACA's individual and employer mandates and "hundreds of millions of dollars in taxes" for the wealthy and the health industry. It would phase out the ACA's Medicaid expansion over three years beginning in 2021 and "make deep cuts" to Medicaid overall. The BCRA would retain subsidies to help low-income people buy insurance but only covers those who make "up to 350% of the federal poverty line-down from the 400% covered under Obamacare." States can opt out of some of the ACA's insurance requirements, but can't waive requirements that insurers accept everyone and charge the same rates (with few exceptions). However, the elderly may have to pay as much as five times more in insurance premiums than younger people for the same health plan.

The BCRA has yet to be scored by the Congressional Budget Office (CBO), which determines the proposal's cost, scope of insurance coverage, what will happen to Medicaid funding, etc. The CBO's score is expected early next week, and the Senate could vote on the BCRA as soon as next Thursday. President Donald Trump said he is "very supportive" of the proposal but shied away from a full endorsement, saying it would be "very good… [after] a little negotiation." Republican Senators Ted Cruz (TX), Ron Johnson (WI), Mike Lee (UT), and Rand Paul (KY) came out against the bill hours after its release because it wouldn't fully "repeal Obamacare and lower [Americans'] health care costs." And POLITICO says there is a "cadre of Republican moderates" who are still making up their mind. Democrats outright oppose the bill, and Senate Minority Leader Chuck Schumer (D-NY) called the bill "even meaner than the House version" for its deep Medicaid cuts, lack of protection for pre-existing conditions, and tax breaks for the wealthy.

The Save Medicaid in Schools Coalition (ASBO International is a member) also issued a statement on the BCRA, expressing disappointment that the Senate bill would end open funding for Medicaid as an entitlement program, which will jeopardize funding for school-based Medicaid programs. If you'd like to join ASBO International in opposing the BCRA and Medicaid cuts, find resources here and here to help with your advocacy efforts as you contact your senators.

POLITICO reports that the Senate will release a discussion draft of its healthcare proposal to replace the Affordable Care Act (ACA) on Thursday and will "set the stage for a vote as soon as next week." Although senators are still negotiating major parts of the bill and details could change as Republicans whip votes to ensure the bill will pass, here's what we know so far:

GOP senators involved in crafting the draft bill are discussing:

• Eliminating several key provisions of the House bill (the American Health Care Act, AHCA), including $115 billion to help states stabilize their insurance markets and funding for ACA health insurance cost-sharing subsidies. (They'd tack these provisions onto a must-pass funding bill for the Children's Health Insurance Program [CHIP] later on instead).
  
  
• Phasing down funding for the ACA's Medicaid expansion over three years, beginning in 2020 or 2021, and shifting children covered under the expansion back into CHIP instead.
  
  
• Repealing all ACA taxes and making 1332 waiver rules less restrictive to give states more leeway to customize their Medicaid programs and health insurance markets.
  
  
• Lowering the annual increase in state Medicaid funding under a per-capita cap below the House's rate starting around 2025 (according to the Center on Budget and Policy Priorities). CBPP says this means "states would have to absorb even deeper cuts in federal Medicaid funding than under the House bill."

Please stay tuned for further updates on the Senate healthcare bill as we receive more information. In the meantime, consider contacting your senators and opposing any healthcare legislation that would cut Medicaid funding and jeopardize school-Medicaid programs. Feel free to use this toolkit to advocate on this issue.

Good morning,

ASBO International has received new information about the Senate healthcare reform proposal from the Save Medicaid in the Schools Coalition, following the House proposal, HR 1628: The American Health Care Act (AHCA), passed in early May.

• Some sections of the Senate healthcare bill have already been scored by the Congressional Budget Office (CBO) and could be revealed later this week. Most of the Republican caucus has not seen the proposed language, which has caused significant concern about the lack of transparency of this process.
  
  
• June 26th is the expected date when the House bill (the AHCA) will be up for debate in the Senate, with a possible vote by as early as June 30th. We are encouraged to comment on the bill now, even before it has been made public.
  
  
• We should assume Medicaid funding cuts will be a part of any final package. Regardless if the amount is $500 billion or $800 billion, we are urged to continue opposing any funding cuts, period.

Please consider joining us and contact your elected officials about this issue. Express opposition to the lack of transparency on this bill, which has had no hearings on (and will likely be voted on with little to no notice to the public). Also, please share your comments on how school-based Medicaid programs would be impacted by the AHCA and Medicaid cuts. Attached are several resources to assist with your advocacy efforts, including:

• ASBO International's/AASA's School Medicaid Report and Medicaid advocacy toolkit,
• FY2015 data on school-Medicaid expenditures by state,
• Contact information for Senate staffers who focus on education issues,
• AASA blog with a Medicaid call script and talking points.

Thank you.

POLITICO and other media outlets are reporting that Senate Republicans will vote on their healthcare repeal plan by the end of June and will send the legislative text to the Congressional Budget Office (CBO) for scoring by the end of this week. The score will determine the proposal's costs, implications for insurance coverage, and other relevant items like the CBO did for the House healthcare proposal in May. The Senate's healthcare proposal has been kept relatively secret, but the Trump administration said that the Senate and House healthcare plans will have a lot of similarities, and Senate leadership said the bills will be about 80% the same.

ASBO International is continuing to work with the Save Medicaid in Schools Coalition to urge Congress to increase transparency with the Senate's healthcare proposal. We would prefer the bill be discussed openly and allow time for debate via public hearings with comments from policy experts. If the Senate repeal plan is essentially the same as the House's American Health Care Act (AHCA), this will be problematic as many citizens and advocacy groups (including ASBO International) have rejected that proposal, especially because of the AHCA's proposal to cut Medicaid funding. We believe it would be best if Congress would work across the aisle to improve our healthcare system in a bipartisan fashion.

If you're interested in joining ASBO International on this advocacy issue, consider contacting your elected officials and urge them to release the Senate healthcare proposal to the public. Also, state your opposition to Medicaid funding cuts and let your representatives know what these cuts would mean for your students.

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials.
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district.
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services.
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

The Senate is expected to vote on a motion to proceed debate on the GOP's healthcare plan today at 2:15 EST. There are few details known about the specific plan, whether it's a full repeal-and-replace or a repeal-only plan. The first option would be the Better Care Reconciliation Act (BCRA) and the second would likely be a plan that was passed by Congress in 2015 but vetoed by President Barack Obama at the time. (Learn more here).

If the motion-to-proceed vote is successful, then the Senate can start debate immediately or start tomorrow morning. There would be 20 hours of debate and opportunity to vote on bill amendments, then Sen. Majority Leader Mitch McConnell will likely substitute something at the last minute for a final vote (without time for the Congressional Budget Office to provide an updated analysis on the bill's impact on the public and budget). Sens. Paul (R-KY), Murkowski (R-AK), Capito (R-WV), Heller, (R-NV), Moran (R-KS), Portman (R-OH), and Lee (R-UT),are still unknown votes, but nevertheless it is expected to be a close one.

In response, ASBO International and the Save Medicaid in Schools Coalition sent another letter to Senate leaders this morning urging them to oppose any plan that would cut Medicaid funding and jeopardize school-based Medicaid programs and services. Please feel free to join us in this effort to oppose Medicaid cuts by contacting your senators and using these resources to support your advocacy efforts.

By now, many of you have likely heard that the vote on the Senate Republican health care bill, the revised "Better Care Reconciliation Act (BCRA)," was delayed after Sen. Majority Leader Mitch McConnell (R-KY) realized there were insufficient votes to move forward. Since Monday, more Republican Senators have come out against BCRA, citing concerns with the bill's provisions to cut Medicaid in particular. This is a direct result of your advocacy efforts to preserve Medicaid funding.

Thank you for continuing to advocate with ASBO International against BCRA and Medicaid funding cuts. Based on feedback we have heard from Hill officials and staff during the 2017 Legislative Advocacy Conference last week, we can confirm that your representatives are hearing you loud and clear. Officials are beginning to understand the impact that Medicaid cuts will have on states, schools, and students, so we encourage you to continue educating them about this issue.

It is premature to say that BCRA has been stopped completely though, as POLITICO reported this morning that the President "has invited all 52 Republic senators for lunch today as part of a last ditch effort to save the GOP's fading health care push." Sen. McConnell will hold a vote to open debate on health care next week, however many are expecting it to fail. Nevertheless, a public vote would provide officials a chance to state their position on BCRA for the record. Meanwhile, other senators are moving to consider bipartisan avenues for health care reform, but nothing concrete has emerged yet. Please stay tuned to this thread for more updates about the GOP's health care reform strategy as we learn more.

Thank you to everyone who advocated with ASBO International against the Senate Republican health care bill, the "Better Care Reconciliation Act (BCRA)," which would cut Medicaid funding by $772 billion over ten years and jeopardize school-Medicaid programs. The Senate has delayed the vote on the bill until after Congress' July 4 recess since there is insufficient support for BCRA in its current form. Senators will rewrite the bill over the recess, get a new score assessing the cost/impact of the legislation, and vote after they return to Washington, D.C. on July 10.

Consequently, ASBO International and the Save Medicaid in Schools Coalition are keeping the pressure on senators and sent a letter urging them to oppose BCRA or any proposal that would cut Medicaid funding and harm students. We will continue advocating on this issue and invite you to join us. Please find several resources below to assist with your advocacy efforts, and consider meeting with your officials while they are at home, working out of their local offices.

• "Ten Ways the Senate's BCRA Harms Children and Offers Worse Care," talking points created by the Children's Defense Fund.
• "Cutting Medicaid: A Prescription to Hurt the Neediest Kids" press release and survey report published by ASBO International and AASA, The School Superintendents Association.
• "If You Haven't Taken Action to Protect Medicaid in Schools, You're Missing a Major Opportunity" blog with advocacy resources by AASA.

Please stay tuned to this thread for more information as we receive further updates.

Yesterday, Republican senators released their draft healthcare bill, the "Better Care Reconciliation Act of 2017" (BCRA) to replace the Affordable Care Act (ACA). See a bill summary here and here and a comparison between the House and Senate health care proposals here.

POLITICO reports the BCRA would eliminate the ACA's individual and employer mandates and "hundreds of millions of dollars in taxes" for the wealthy and the health industry. It would phase out the ACA's Medicaid expansion over three years beginning in 2021 and "make deep cuts" to Medicaid overall. The BCRA would retain subsidies to help low-income people buy insurance but only covers those who make "up to 350% of the federal poverty line-down from the 400% covered under Obamacare." States can opt out of some of the ACA's insurance requirements, but can't waive requirements that insurers accept everyone and charge the same rates (with few exceptions). However, the elderly may have to pay as much as five times more in insurance premiums than younger people for the same health plan.

The BCRA has yet to be scored by the Congressional Budget Office (CBO), which determines the proposal's cost, scope of insurance coverage, what will happen to Medicaid funding, etc. The CBO's score is expected early next week, and the Senate could vote on the BCRA as soon as next Thursday. President Donald Trump said he is "very supportive" of the proposal but shied away from a full endorsement, saying it would be "very good… [after] a little negotiation." Republican Senators Ted Cruz (TX), Ron Johnson (WI), Mike Lee (UT), and Rand Paul (KY) came out against the bill hours after its release because it wouldn't fully "repeal Obamacare and lower [Americans'] health care costs." And POLITICO says there is a "cadre of Republican moderates" who are still making up their mind. Democrats outright oppose the bill, and Senate Minority Leader Chuck Schumer (D-NY) called the bill "even meaner than the House version" for its deep Medicaid cuts, lack of protection for pre-existing conditions, and tax breaks for the wealthy.

The Save Medicaid in Schools Coalition (ASBO International is a member) also issued a statement on the BCRA, expressing disappointment that the Senate bill would end open funding for Medicaid as an entitlement program, which will jeopardize funding for school-based Medicaid programs. If you'd like to join ASBO International in opposing the BCRA and Medicaid cuts, find resources here and here to help with your advocacy efforts as you contact your senators.

POLITICO reports that the Senate will release a discussion draft of its healthcare proposal to replace the Affordable Care Act (ACA) on Thursday and will "set the stage for a vote as soon as next week." Although senators are still negotiating major parts of the bill and details could change as Republicans whip votes to ensure the bill will pass, here's what we know so far:

GOP senators involved in crafting the draft bill are discussing:

• Eliminating several key provisions of the House bill (the American Health Care Act, AHCA), including $115 billion to help states stabilize their insurance markets and funding for ACA health insurance cost-sharing subsidies. (They'd tack these provisions onto a must-pass funding bill for the Children's Health Insurance Program [CHIP] later on instead).
  
  
• Phasing down funding for the ACA's Medicaid expansion over three years, beginning in 2020 or 2021, and shifting children covered under the expansion back into CHIP instead.
  
  
• Repealing all ACA taxes and making 1332 waiver rules less restrictive to give states more leeway to customize their Medicaid programs and health insurance markets.
  
  
• Lowering the annual increase in state Medicaid funding under a per-capita cap below the House's rate starting around 2025 (according to the Center on Budget and Policy Priorities). CBPP says this means "states would have to absorb even deeper cuts in federal Medicaid funding than under the House bill."

Please stay tuned for further updates on the Senate healthcare bill as we receive more information. In the meantime, consider contacting your senators and opposing any healthcare legislation that would cut Medicaid funding and jeopardize school-Medicaid programs. Feel free to use this toolkit to advocate on this issue.

Good morning,

ASBO International has received new information about the Senate healthcare reform proposal from the Save Medicaid in the Schools Coalition, following the House proposal, HR 1628: The American Health Care Act (AHCA), passed in early May.

• Some sections of the Senate healthcare bill have already been scored by the Congressional Budget Office (CBO) and could be revealed later this week. Most of the Republican caucus has not seen the proposed language, which has caused significant concern about the lack of transparency of this process.
  
  
• June 26th is the expected date when the House bill (the AHCA) will be up for debate in the Senate, with a possible vote by as early as June 30th. We are encouraged to comment on the bill now, even before it has been made public.
  
  
• We should assume Medicaid funding cuts will be a part of any final package. Regardless if the amount is $500 billion or $800 billion, we are urged to continue opposing any funding cuts, period.

Please consider joining us and contact your elected officials about this issue. Express opposition to the lack of transparency on this bill, which has had no hearings on (and will likely be voted on with little to no notice to the public). Also, please share your comments on how school-based Medicaid programs would be impacted by the AHCA and Medicaid cuts. Attached are several resources to assist with your advocacy efforts, including:

• ASBO International's/AASA's School Medicaid Report and Medicaid advocacy toolkit,
• FY2015 data on school-Medicaid expenditures by state,
• Contact information for Senate staffers who focus on education issues,
• AASA blog with a Medicaid call script and talking points.

Thank you.

POLITICO and other media outlets are reporting that Senate Republicans will vote on their healthcare repeal plan by the end of June and will send the legislative text to the Congressional Budget Office (CBO) for scoring by the end of this week. The score will determine the proposal's costs, implications for insurance coverage, and other relevant items like the CBO did for the House healthcare proposal in May. The Senate's healthcare proposal has been kept relatively secret, but the Trump administration said that the Senate and House healthcare plans will have a lot of similarities, and Senate leadership said the bills will be about 80% the same.

ASBO International is continuing to work with the Save Medicaid in Schools Coalition to urge Congress to increase transparency with the Senate's healthcare proposal. We would prefer the bill be discussed openly and allow time for debate via public hearings with comments from policy experts. If the Senate repeal plan is essentially the same as the House's American Health Care Act (AHCA), this will be problematic as many citizens and advocacy groups (including ASBO International) have rejected that proposal, especially because of the AHCA's proposal to cut Medicaid funding. We believe it would be best if Congress would work across the aisle to improve our healthcare system in a bipartisan fashion.

If you're interested in joining ASBO International on this advocacy issue, consider contacting your elected officials and urge them to release the Senate healthcare proposal to the public. Also, state your opposition to Medicaid funding cuts and let your representatives know what these cuts would mean for your students.

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials.
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district.
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services.
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

With twelve days left before the end of the 2017 federal fiscal year (FY17), Republicans have until September 30 to pass a partisan healthcare reform bill via a 50-vote, simple majority process known as "budget reconciliation," or else rely on their Democrat colleagues to help pass health care legislation later on. Currently there are two healthcare bills in play:

• Graham-Cassidy bill. Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) proposed a bill that would replace ACA funding for its Medicaid expansion program and private insurance subsidies with block grants to states, POLITICO says. "Federal funding available for all states would start at $136 billion in 2020 and grow to $200 billion by 2026," or just under $1.2 trillion. Among other items, the proposal would repeal the individual and employer mandates, rescind several regulations regarding health savings accounts, implement a new federal funding formula to states, and more.
  
  Like prior Republican healthcare proposals, the Graham-Cassidy bill would reduce Medicaid funding to states by transforming it into a budgeted, block-grant program instead of maintaining the open-funded structure it currently has. Capping or reducing Medicaid funding will jeopardize school-based Medicaid programs, since states will have limited Medicaid dollars available to reimburse service providers, and hospitals/clinics will be prioritized over schools. Moreover, block grants don't provide additional funding for public health emergencies, recessions, or natural disasters – when more Medicaid funding is often needed. Even though some Senate Republicans are skeptical about it passing, Sen. Mitch McConnell and other GOP leaders are steadily whipping support for it to ensure it does.
  
  
• Alexander-Murray proposal. Meanwhile, Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) are working on a bipartisan approach to reform the Affordable Care Act and fix immediate issues, including lowering insurance premiums, increasing healthcare options, and stabilizing the ACA insurance markets for 2018. Alexander and Murray serve on the Senate Health, Education, Labor, and Pensions Committee, which held several ACA hearings over the last few weeks, and hope to pass a "narrow stabilization measure" by the end of the month, before the next enrollment period begins. This would be the first step of several to reform the healthcare system, and would not change Medicaid's current financing structure (for now) as the Graham-Cassidy bill and prior GOP proposals would.

Advocacy Opportunity
ASBO International and the Save Medicaid in Schools Coalition are asking senators to vote NO on the Graham-Cassidy healthcare bill and any proposal that cuts/reduces Medicaid funding for states and schools. Please consider joining us and ask your senators to protect Medicaid; share how school Medicaid programs help your district serve your students. 

The Senate is expected to vote on a motion to proceed debate on the GOP's healthcare plan today at 2:15 EST. There are few details known about the specific plan, whether it's a full repeal-and-replace or a repeal-only plan. The first option would be the Better Care Reconciliation Act (BCRA) and the second would likely be a plan that was passed by Congress in 2015 but vetoed by President Barack Obama at the time. (Learn more here).

If the motion-to-proceed vote is successful, then the Senate can start debate immediately or start tomorrow morning. There would be 20 hours of debate and opportunity to vote on bill amendments, then Sen. Majority Leader Mitch McConnell will likely substitute something at the last minute for a final vote (without time for the Congressional Budget Office to provide an updated analysis on the bill's impact on the public and budget). Sens. Paul (R-KY), Murkowski (R-AK), Capito (R-WV), Heller, (R-NV), Moran (R-KS), Portman (R-OH), and Lee (R-UT),are still unknown votes, but nevertheless it is expected to be a close one.

In response, ASBO International and the Save Medicaid in Schools Coalition sent another letter to Senate leaders this morning urging them to oppose any plan that would cut Medicaid funding and jeopardize school-based Medicaid programs and services. Please feel free to join us in this effort to oppose Medicaid cuts by contacting your senators and using these resources to support your advocacy efforts.

By now, many of you have likely heard that the vote on the Senate Republican health care bill, the revised "Better Care Reconciliation Act (BCRA)," was delayed after Sen. Majority Leader Mitch McConnell (R-KY) realized there were insufficient votes to move forward. Since Monday, more Republican Senators have come out against BCRA, citing concerns with the bill's provisions to cut Medicaid in particular. This is a direct result of your advocacy efforts to preserve Medicaid funding.

Thank you for continuing to advocate with ASBO International against BCRA and Medicaid funding cuts. Based on feedback we have heard from Hill officials and staff during the 2017 Legislative Advocacy Conference last week, we can confirm that your representatives are hearing you loud and clear. Officials are beginning to understand the impact that Medicaid cuts will have on states, schools, and students, so we encourage you to continue educating them about this issue.

It is premature to say that BCRA has been stopped completely though, as POLITICO reported this morning that the President "has invited all 52 Republic senators for lunch today as part of a last ditch effort to save the GOP's fading health care push." Sen. McConnell will hold a vote to open debate on health care next week, however many are expecting it to fail. Nevertheless, a public vote would provide officials a chance to state their position on BCRA for the record. Meanwhile, other senators are moving to consider bipartisan avenues for health care reform, but nothing concrete has emerged yet. Please stay tuned to this thread for more updates about the GOP's health care reform strategy as we learn more.

Thank you to everyone who advocated with ASBO International against the Senate Republican health care bill, the "Better Care Reconciliation Act (BCRA)," which would cut Medicaid funding by $772 billion over ten years and jeopardize school-Medicaid programs. The Senate has delayed the vote on the bill until after Congress' July 4 recess since there is insufficient support for BCRA in its current form. Senators will rewrite the bill over the recess, get a new score assessing the cost/impact of the legislation, and vote after they return to Washington, D.C. on July 10.

Consequently, ASBO International and the Save Medicaid in Schools Coalition are keeping the pressure on senators and sent a letter urging them to oppose BCRA or any proposal that would cut Medicaid funding and harm students. We will continue advocating on this issue and invite you to join us. Please find several resources below to assist with your advocacy efforts, and consider meeting with your officials while they are at home, working out of their local offices.

• "Ten Ways the Senate's BCRA Harms Children and Offers Worse Care," talking points created by the Children's Defense Fund.
• "Cutting Medicaid: A Prescription to Hurt the Neediest Kids" press release and survey report published by ASBO International and AASA, The School Superintendents Association.
• "If You Haven't Taken Action to Protect Medicaid in Schools, You're Missing a Major Opportunity" blog with advocacy resources by AASA.

Please stay tuned to this thread for more information as we receive further updates.

Yesterday, Republican senators released their draft healthcare bill, the "Better Care Reconciliation Act of 2017" (BCRA) to replace the Affordable Care Act (ACA). See a bill summary here and here and a comparison between the House and Senate health care proposals here.

POLITICO reports the BCRA would eliminate the ACA's individual and employer mandates and "hundreds of millions of dollars in taxes" for the wealthy and the health industry. It would phase out the ACA's Medicaid expansion over three years beginning in 2021 and "make deep cuts" to Medicaid overall. The BCRA would retain subsidies to help low-income people buy insurance but only covers those who make "up to 350% of the federal poverty line-down from the 400% covered under Obamacare." States can opt out of some of the ACA's insurance requirements, but can't waive requirements that insurers accept everyone and charge the same rates (with few exceptions). However, the elderly may have to pay as much as five times more in insurance premiums than younger people for the same health plan.

The BCRA has yet to be scored by the Congressional Budget Office (CBO), which determines the proposal's cost, scope of insurance coverage, what will happen to Medicaid funding, etc. The CBO's score is expected early next week, and the Senate could vote on the BCRA as soon as next Thursday. President Donald Trump said he is "very supportive" of the proposal but shied away from a full endorsement, saying it would be "very good… [after] a little negotiation." Republican Senators Ted Cruz (TX), Ron Johnson (WI), Mike Lee (UT), and Rand Paul (KY) came out against the bill hours after its release because it wouldn't fully "repeal Obamacare and lower [Americans'] health care costs." And POLITICO says there is a "cadre of Republican moderates" who are still making up their mind. Democrats outright oppose the bill, and Senate Minority Leader Chuck Schumer (D-NY) called the bill "even meaner than the House version" for its deep Medicaid cuts, lack of protection for pre-existing conditions, and tax breaks for the wealthy.

The Save Medicaid in Schools Coalition (ASBO International is a member) also issued a statement on the BCRA, expressing disappointment that the Senate bill would end open funding for Medicaid as an entitlement program, which will jeopardize funding for school-based Medicaid programs. If you'd like to join ASBO International in opposing the BCRA and Medicaid cuts, find resources here and here to help with your advocacy efforts as you contact your senators.

POLITICO reports that the Senate will release a discussion draft of its healthcare proposal to replace the Affordable Care Act (ACA) on Thursday and will "set the stage for a vote as soon as next week." Although senators are still negotiating major parts of the bill and details could change as Republicans whip votes to ensure the bill will pass, here's what we know so far:

GOP senators involved in crafting the draft bill are discussing:

• Eliminating several key provisions of the House bill (the American Health Care Act, AHCA), including $115 billion to help states stabilize their insurance markets and funding for ACA health insurance cost-sharing subsidies. (They'd tack these provisions onto a must-pass funding bill for the Children's Health Insurance Program [CHIP] later on instead).
  
  
• Phasing down funding for the ACA's Medicaid expansion over three years, beginning in 2020 or 2021, and shifting children covered under the expansion back into CHIP instead.
  
  
• Repealing all ACA taxes and making 1332 waiver rules less restrictive to give states more leeway to customize their Medicaid programs and health insurance markets.
  
  
• Lowering the annual increase in state Medicaid funding under a per-capita cap below the House's rate starting around 2025 (according to the Center on Budget and Policy Priorities). CBPP says this means "states would have to absorb even deeper cuts in federal Medicaid funding than under the House bill."

Please stay tuned for further updates on the Senate healthcare bill as we receive more information. In the meantime, consider contacting your senators and opposing any healthcare legislation that would cut Medicaid funding and jeopardize school-Medicaid programs. Feel free to use this toolkit to advocate on this issue.

Good morning,

ASBO International has received new information about the Senate healthcare reform proposal from the Save Medicaid in the Schools Coalition, following the House proposal, HR 1628: The American Health Care Act (AHCA), passed in early May.

• Some sections of the Senate healthcare bill have already been scored by the Congressional Budget Office (CBO) and could be revealed later this week. Most of the Republican caucus has not seen the proposed language, which has caused significant concern about the lack of transparency of this process.
  
  
• June 26th is the expected date when the House bill (the AHCA) will be up for debate in the Senate, with a possible vote by as early as June 30th. We are encouraged to comment on the bill now, even before it has been made public.
  
  
• We should assume Medicaid funding cuts will be a part of any final package. Regardless if the amount is $500 billion or $800 billion, we are urged to continue opposing any funding cuts, period.

Please consider joining us and contact your elected officials about this issue. Express opposition to the lack of transparency on this bill, which has had no hearings on (and will likely be voted on with little to no notice to the public). Also, please share your comments on how school-based Medicaid programs would be impacted by the AHCA and Medicaid cuts. Attached are several resources to assist with your advocacy efforts, including:

• ASBO International's/AASA's School Medicaid Report and Medicaid advocacy toolkit,
• FY2015 data on school-Medicaid expenditures by state,
• Contact information for Senate staffers who focus on education issues,
• AASA blog with a Medicaid call script and talking points.

Thank you.

POLITICO and other media outlets are reporting that Senate Republicans will vote on their healthcare repeal plan by the end of June and will send the legislative text to the Congressional Budget Office (CBO) for scoring by the end of this week. The score will determine the proposal's costs, implications for insurance coverage, and other relevant items like the CBO did for the House healthcare proposal in May. The Senate's healthcare proposal has been kept relatively secret, but the Trump administration said that the Senate and House healthcare plans will have a lot of similarities, and Senate leadership said the bills will be about 80% the same.

ASBO International is continuing to work with the Save Medicaid in Schools Coalition to urge Congress to increase transparency with the Senate's healthcare proposal. We would prefer the bill be discussed openly and allow time for debate via public hearings with comments from policy experts. If the Senate repeal plan is essentially the same as the House's American Health Care Act (AHCA), this will be problematic as many citizens and advocacy groups (including ASBO International) have rejected that proposal, especially because of the AHCA's proposal to cut Medicaid funding. We believe it would be best if Congress would work across the aisle to improve our healthcare system in a bipartisan fashion.

If you're interested in joining ASBO International on this advocacy issue, consider contacting your elected officials and urge them to release the Senate healthcare proposal to the public. Also, state your opposition to Medicaid funding cuts and let your representatives know what these cuts would mean for your students.

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials.
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district.
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services.
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.
  
  

With twelve days left before the end of the 2017 federal fiscal year (FY17), Republicans have until September 30 to pass a partisan healthcare reform bill via a 50-vote, simple majority process known as "budget reconciliation," or else rely on their Democrat colleagues to help pass health care legislation later on. Currently there are two healthcare bills in play:

• Graham-Cassidy bill. Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) proposed a bill that would replace ACA funding for its Medicaid expansion program and private insurance subsidies with block grants to states, POLITICO says. "Federal funding available for all states would start at $136 billion in 2020 and grow to $200 billion by 2026," or just under $1.2 trillion. Among other items, the proposal would repeal the individual and employer mandates, rescind several regulations regarding health savings accounts, implement a new federal funding formula to states, and more.
  
  Like prior Republican healthcare proposals, the Graham-Cassidy bill would reduce Medicaid funding to states by transforming it into a budgeted, block-grant program instead of maintaining the open-funded structure it currently has. Capping or reducing Medicaid funding will jeopardize school-based Medicaid programs, since states will have limited Medicaid dollars available to reimburse service providers, and hospitals/clinics will be prioritized over schools. Moreover, block grants don't provide additional funding for public health emergencies, recessions, or natural disasters – when more Medicaid funding is often needed. Even though some Senate Republicans are skeptical about it passing, Sen. Mitch McConnell and other GOP leaders are steadily whipping support for it to ensure it does.
  
  
• Alexander-Murray proposal. Meanwhile, Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) are working on a bipartisan approach to reform the Affordable Care Act and fix immediate issues, including lowering insurance premiums, increasing healthcare options, and stabilizing the ACA insurance markets for 2018. Alexander and Murray serve on the Senate Health, Education, Labor, and Pensions Committee, which held several ACA hearings over the last few weeks, and hope to pass a "narrow stabilization measure" by the end of the month, before the next enrollment period begins. This would be the first step of several to reform the healthcare system, and would not change Medicaid's current financing structure (for now) as the Graham-Cassidy bill and prior GOP proposals would.

Advocacy Opportunity
ASBO International and the Save Medicaid in Schools Coalition are asking senators to vote NO on the Graham-Cassidy healthcare bill and any proposal that cuts/reduces Medicaid funding for states and schools. Please consider joining us and ask your senators to protect Medicaid; share how school Medicaid programs help your district serve your students. 

The Senate is expected to vote on a motion to proceed debate on the GOP's healthcare plan today at 2:15 EST. There are few details known about the specific plan, whether it's a full repeal-and-replace or a repeal-only plan. The first option would be the Better Care Reconciliation Act (BCRA) and the second would likely be a plan that was passed by Congress in 2015 but vetoed by President Barack Obama at the time. (Learn more here).

If the motion-to-proceed vote is successful, then the Senate can start debate immediately or start tomorrow morning. There would be 20 hours of debate and opportunity to vote on bill amendments, then Sen. Majority Leader Mitch McConnell will likely substitute something at the last minute for a final vote (without time for the Congressional Budget Office to provide an updated analysis on the bill's impact on the public and budget). Sens. Paul (R-KY), Murkowski (R-AK), Capito (R-WV), Heller, (R-NV), Moran (R-KS), Portman (R-OH), and Lee (R-UT),are still unknown votes, but nevertheless it is expected to be a close one.

In response, ASBO International and the Save Medicaid in Schools Coalition sent another letter to Senate leaders this morning urging them to oppose any plan that would cut Medicaid funding and jeopardize school-based Medicaid programs and services. Please feel free to join us in this effort to oppose Medicaid cuts by contacting your senators and using these resources to support your advocacy efforts.

By now, many of you have likely heard that the vote on the Senate Republican health care bill, the revised "Better Care Reconciliation Act (BCRA)," was delayed after Sen. Majority Leader Mitch McConnell (R-KY) realized there were insufficient votes to move forward. Since Monday, more Republican Senators have come out against BCRA, citing concerns with the bill's provisions to cut Medicaid in particular. This is a direct result of your advocacy efforts to preserve Medicaid funding.

Thank you for continuing to advocate with ASBO International against BCRA and Medicaid funding cuts. Based on feedback we have heard from Hill officials and staff during the 2017 Legislative Advocacy Conference last week, we can confirm that your representatives are hearing you loud and clear. Officials are beginning to understand the impact that Medicaid cuts will have on states, schools, and students, so we encourage you to continue educating them about this issue.

It is premature to say that BCRA has been stopped completely though, as POLITICO reported this morning that the President "has invited all 52 Republic senators for lunch today as part of a last ditch effort to save the GOP's fading health care push." Sen. McConnell will hold a vote to open debate on health care next week, however many are expecting it to fail. Nevertheless, a public vote would provide officials a chance to state their position on BCRA for the record. Meanwhile, other senators are moving to consider bipartisan avenues for health care reform, but nothing concrete has emerged yet. Please stay tuned to this thread for more updates about the GOP's health care reform strategy as we learn more.

Thank you to everyone who advocated with ASBO International against the Senate Republican health care bill, the "Better Care Reconciliation Act (BCRA)," which would cut Medicaid funding by $772 billion over ten years and jeopardize school-Medicaid programs. The Senate has delayed the vote on the bill until after Congress' July 4 recess since there is insufficient support for BCRA in its current form. Senators will rewrite the bill over the recess, get a new score assessing the cost/impact of the legislation, and vote after they return to Washington, D.C. on July 10.

Consequently, ASBO International and the Save Medicaid in Schools Coalition are keeping the pressure on senators and sent a letter urging them to oppose BCRA or any proposal that would cut Medicaid funding and harm students. We will continue advocating on this issue and invite you to join us. Please find several resources below to assist with your advocacy efforts, and consider meeting with your officials while they are at home, working out of their local offices.

• "Ten Ways the Senate's BCRA Harms Children and Offers Worse Care," talking points created by the Children's Defense Fund.
• "Cutting Medicaid: A Prescription to Hurt the Neediest Kids" press release and survey report published by ASBO International and AASA, The School Superintendents Association.
• "If You Haven't Taken Action to Protect Medicaid in Schools, You're Missing a Major Opportunity" blog with advocacy resources by AASA.

Please stay tuned to this thread for more information as we receive further updates.

Yesterday, Republican senators released their draft healthcare bill, the "Better Care Reconciliation Act of 2017" (BCRA) to replace the Affordable Care Act (ACA). See a bill summary here and here and a comparison between the House and Senate health care proposals here.

POLITICO reports the BCRA would eliminate the ACA's individual and employer mandates and "hundreds of millions of dollars in taxes" for the wealthy and the health industry. It would phase out the ACA's Medicaid expansion over three years beginning in 2021 and "make deep cuts" to Medicaid overall. The BCRA would retain subsidies to help low-income people buy insurance but only covers those who make "up to 350% of the federal poverty line-down from the 400% covered under Obamacare." States can opt out of some of the ACA's insurance requirements, but can't waive requirements that insurers accept everyone and charge the same rates (with few exceptions). However, the elderly may have to pay as much as five times more in insurance premiums than younger people for the same health plan.

The BCRA has yet to be scored by the Congressional Budget Office (CBO), which determines the proposal's cost, scope of insurance coverage, what will happen to Medicaid funding, etc. The CBO's score is expected early next week, and the Senate could vote on the BCRA as soon as next Thursday. President Donald Trump said he is "very supportive" of the proposal but shied away from a full endorsement, saying it would be "very good… [after] a little negotiation." Republican Senators Ted Cruz (TX), Ron Johnson (WI), Mike Lee (UT), and Rand Paul (KY) came out against the bill hours after its release because it wouldn't fully "repeal Obamacare and lower [Americans'] health care costs." And POLITICO says there is a "cadre of Republican moderates" who are still making up their mind. Democrats outright oppose the bill, and Senate Minority Leader Chuck Schumer (D-NY) called the bill "even meaner than the House version" for its deep Medicaid cuts, lack of protection for pre-existing conditions, and tax breaks for the wealthy.

The Save Medicaid in Schools Coalition (ASBO International is a member) also issued a statement on the BCRA, expressing disappointment that the Senate bill would end open funding for Medicaid as an entitlement program, which will jeopardize funding for school-based Medicaid programs. If you'd like to join ASBO International in opposing the BCRA and Medicaid cuts, find resources here and here to help with your advocacy efforts as you contact your senators.

POLITICO reports that the Senate will release a discussion draft of its healthcare proposal to replace the Affordable Care Act (ACA) on Thursday and will "set the stage for a vote as soon as next week." Although senators are still negotiating major parts of the bill and details could change as Republicans whip votes to ensure the bill will pass, here's what we know so far:

GOP senators involved in crafting the draft bill are discussing:

• Eliminating several key provisions of the House bill (the American Health Care Act, AHCA), including $115 billion to help states stabilize their insurance markets and funding for ACA health insurance cost-sharing subsidies. (They'd tack these provisions onto a must-pass funding bill for the Children's Health Insurance Program [CHIP] later on instead).
  
  
• Phasing down funding for the ACA's Medicaid expansion over three years, beginning in 2020 or 2021, and shifting children covered under the expansion back into CHIP instead.
  
  
• Repealing all ACA taxes and making 1332 waiver rules less restrictive to give states more leeway to customize their Medicaid programs and health insurance markets.
  
  
• Lowering the annual increase in state Medicaid funding under a per-capita cap below the House's rate starting around 2025 (according to the Center on Budget and Policy Priorities). CBPP says this means "states would have to absorb even deeper cuts in federal Medicaid funding than under the House bill."

Please stay tuned for further updates on the Senate healthcare bill as we receive more information. In the meantime, consider contacting your senators and opposing any healthcare legislation that would cut Medicaid funding and jeopardize school-Medicaid programs. Feel free to use this toolkit to advocate on this issue.

Good morning,

ASBO International has received new information about the Senate healthcare reform proposal from the Save Medicaid in the Schools Coalition, following the House proposal, HR 1628: The American Health Care Act (AHCA), passed in early May.

• Some sections of the Senate healthcare bill have already been scored by the Congressional Budget Office (CBO) and could be revealed later this week. Most of the Republican caucus has not seen the proposed language, which has caused significant concern about the lack of transparency of this process.
  
  
• June 26th is the expected date when the House bill (the AHCA) will be up for debate in the Senate, with a possible vote by as early as June 30th. We are encouraged to comment on the bill now, even before it has been made public.
  
  
• We should assume Medicaid funding cuts will be a part of any final package. Regardless if the amount is $500 billion or $800 billion, we are urged to continue opposing any funding cuts, period.

Please consider joining us and contact your elected officials about this issue. Express opposition to the lack of transparency on this bill, which has had no hearings on (and will likely be voted on with little to no notice to the public). Also, please share your comments on how school-based Medicaid programs would be impacted by the AHCA and Medicaid cuts. Attached are several resources to assist with your advocacy efforts, including:

• ASBO International's/AASA's School Medicaid Report and Medicaid advocacy toolkit,
• FY2015 data on school-Medicaid expenditures by state,
• Contact information for Senate staffers who focus on education issues,
• AASA blog with a Medicaid call script and talking points.

Thank you.

POLITICO and other media outlets are reporting that Senate Republicans will vote on their healthcare repeal plan by the end of June and will send the legislative text to the Congressional Budget Office (CBO) for scoring by the end of this week. The score will determine the proposal's costs, implications for insurance coverage, and other relevant items like the CBO did for the House healthcare proposal in May. The Senate's healthcare proposal has been kept relatively secret, but the Trump administration said that the Senate and House healthcare plans will have a lot of similarities, and Senate leadership said the bills will be about 80% the same.

ASBO International is continuing to work with the Save Medicaid in Schools Coalition to urge Congress to increase transparency with the Senate's healthcare proposal. We would prefer the bill be discussed openly and allow time for debate via public hearings with comments from policy experts. If the Senate repeal plan is essentially the same as the House's American Health Care Act (AHCA), this will be problematic as many citizens and advocacy groups (including ASBO International) have rejected that proposal, especially because of the AHCA's proposal to cut Medicaid funding. We believe it would be best if Congress would work across the aisle to improve our healthcare system in a bipartisan fashion.

If you're interested in joining ASBO International on this advocacy issue, consider contacting your elected officials and urge them to release the Senate healthcare proposal to the public. Also, state your opposition to Medicaid funding cuts and let your representatives know what these cuts would mean for your students.

House Republicans are delaying their vote on the latest version of the American Health Care Act (AHCA), which was expected to happen today or tomorrow. The Hill is keeping an ongoing tally of where all House Republicans stand on the legislation for those who'd like to know what their elected officials' positions are. Sources on the Hill say that a vote could still be scheduled next week, so please continue contacting your elected officials about opposing the AHCA if you're interested in advocating with ASBO International on this issue.

ASBO International has received word that House Republicans are again attempting to repeal and replace the Affordable Care Act (ACA) and cut Medicaid with a modified version of their American Health Care Act (AHCA) proposal. While a vote has not been scheduled, experts estimate one could happen as soon as tomorrow or Saturday.

This bill would dramatically change Medicaid's financing structure and significantly impact a school's ability to provide critical health services to low-income students and those with disabilities. Under the AHCA, every child would receive a capped amount of Medicaid funding for their healthcare needs regardless of how sick/disabled they are or the services they need. Healthcare experts believe that these per-capita Medicaid caps will lead to rationed healthcare options for children, as states will have less Medicaid funding under the AHCA. Cutting schools out of the Medicaid reimbursement process may become an obvious choice for states as schools compete with hospitals, primary care physicians, and other providers for limited resources.

ASBO International is working with the Save Medicaid in the Schools Coalition to urge House Republicans to vote "NO" on the latest AHCA bill and we invite you to join us in this initiative. Please feel free to use these resources to advocate on this issue. You can contact your elected officials via the Congressional Switchboard at 202.224.3121.

• Medicaid fact sheet and sample letter template that provides more information about the AHCA and proposal to reform Medicaid, including a sample letter and contact information to get in touch with your elected officials.
  
  
• Data maps that show how many children rely on Medicaid/CHIP by state or congressional district.
  
  
• Center for American Progress article on how AHCA's Medicaid cuts will affect school-based health services.
  
  
• Center on Budget and Policy Priorities report on how Medicaid helps school children.