US House Healthcare Bill Threatens Funding for Children with Disabilities

Affordable Care Act patient book

The House Republicans passed a bill last week to overhaul the Affordable Care Act. While the bill must still obtain Senate approval to move forward, it contains several provisions that are concerning to the disability community.

One of them, buried within the text of the bill now called the American Health Care Act, is a 25% cut to the federal Medicaid program (called MassHealth in Massachusetts), which provides funding for services for children with disabilities who qualify. This slashing of Medicaid funds poses enormous danger to school districts nationwide who rely on the federal funding stream to cover costs for special education services such as physical therapists, occupational therapists, and equipment such as wheelchairs, playgrounds, and other accessible facilities. Medicaid-covered hearing and vision screenings at school may also disappear, removing a key means of early identification and treatment for families who don’t visit doctors frequently.

Putting them in a very difficult position, school districts would be required to provide the same services under the Individuals with Disabilities Education Act (IDEA) without the Medicaid funding that is necessary to provide many of these services. IDEA is the federal law that states that children with disabilities are entitled to receive a free and appropriate public education (FAPE), including special education and related services.

How the Medicaid cut would work

The bill proposes to restructure Medicaid funding from an entitlement program, which guarantees certain benefits to all people who meet the qualifying criteria regardless of cost, to a per capita cap system, which means that each person who qualifies for Medicaid will receive a fixed amount of money to cover their costs. Yet that fixed amount may not cover all of the services that a person needs.

As the Medicaid system works in its current form, school districts provide certain healthcare services to students who are Medicaid-eligible and receive reimbursement through the federal Medicaid system. Under the new system, states would not be required to consider schools as Medicaid providers, which means districts would need to provide the same services without the accompanying funds.

Though this proposed cut hasn’t made headlines on the nightly news, disability advocates are making their voices heard. A coalition of over 50 groups outlined their concerns in a letter to leaders of the House and Senate this week. Cuts to general education, higher taxes, and fewer health services are some of the other concerns they express.

Do you want to share your concerns? Call your Senator, as the Senate will soon consider this bill (or create one of their own). Share your child’s story and how being forced to remove necessary services will negatively impact their – and your – lives.

To learn more about MassHealth and whether you qualify, visit our Guide: