After a postponement of Thursday’s (3/23) scheduled vote, the U.S. House of Representatives may take up its bill to repeal and replace sections of the Affordable Care Act (ACA), also called Obamacare, later today (3/24).
The bill includes numerous changes to the ACA, but most significantly for schools, the bill modifies how the federal government will fund the Medicaid program (also known as Medical Assistance or MA), including how the federal government funds their share of state Medicaid Costs. The bill would enact a per capita cap on federal Medicaid payments to states, thus jeopardizing the Medicaid funding schools receive to provide healthcare services to students, including students with disabilities.
Under the bill, the per capita cap is set at a lower level than healthcare costs are expected to grow under Medicaid in future years. Schools receive approximately $4 billion in Medicaid funding each year.
The healthcare services provided to students with disabilities and students in poverty in schools include speech-language pathology, occupational and physical therapy, mental and behavioral health services, vision and hearing screenings, diabetes and asthma management, wheelchairs and hearing aids, among others.
Late Tuesday evening, Republican leaders agreed to make several changes to the Medicaid proposal in an attempt to persuade Republican members of the Freedom Caucus, a group of about 30 of the most conservative House members who have opposed the bill, to vote for the legislation. Specifically, the bill was modified to create more flexibility to states in administering their Medicaid program. Specifically, the amendment would allow states to opt out of the per capita allotment baseline and instead receive federal funds through a block grant in a fixed-dollar allotment. The bill was also amended to give states the ability to implement optional work requirements for their Medicaid programs and to provide a more generous reimbursement for elderly and disabled Medicaid enrollees. Although the amendments addressed the concerns of some members, in the end, the amendments did not appear to have persuaded enough members of the Freedom Caucus to vote to approve the bill.
Stay tuned. We will provide updates as information becomes available.