Medicaid helps schools pay for speech therapy, nursing aides, wheelchairs and other services for students with disabilities.

A health-care bill approved by the U.S. House on Thursday to repeal much of the Affordable Care Act would cost Ohio schools millions in Medicaid funding.

Medicaid, the tax-funded health-care program for the poor and disabled, helps schools pay for speech therapy, nursing aides, wheelchairs and other services for students with disabilities. It also reimburses schools for health and wellness care to children in poverty.

“It’s literally millions of dollars at stake for school districts,” said Damon Asbury, legislative director of the Ohio School Boards Association. “What’s going to replace it? Because right now, those costs will flow back to schools.”

The bill passed by the House, if approved by the Senate, would cut federal Medicaid funding by $880 billion between 2017 and 2026 and impose per-capita funding caps on beneficiaries including children, putting the 30-year-old Medicaid School Program at risk.

“Special education services are mandated no matter what they cost. Because federal and state dollars only cover a portion, this drastic cut in federal funds would likely necessitate increases in local school levies, shifting the costs to local communities,” said Brandi Slaughter, chief executive officer for Voices for Ohio’s Children.

“Healthy kids learn better. A reduction of Medicaid revenue to schools undermines their ability to provide access to critical health services. The bill passed by (the House) will result in the loss of Medicaid funding, which will make it harder for schools to keep nurses, counselors, speech therapists and other health professionals on staff and force districts to divert funding from vital — but not mandated — programs such as sports and the arts to special education.”

The School Superintendents Association, a national advocacy group, estimated that schools receive about $4 billion through the program each year to cover services and equipment to Medicaid-eligible students.

The loss in federal aid “will compel states to ration health care for children,” a coalition led by the superintendents association wrote this week in a letter to congressional leaders.

“School-based health services are mandated on states, and those mandates do not cease simply because Medicaid funds are capped,” the letter states.

In Ohio, about 580 school districts receive funds through the program.

In 2013, the most-recent year for which numbers are available, the schools received $75 million in combined state and federal Medicaid reimbursements, according to the Ohio Department of Medicaid. The House bill puts in jeopardy the federal portion of that aid, which was nearly $47 million in 2013.

Ohio’s large urban districts would be hit the hardest, but some suburban districts also would lose, state data showed.

Columbus schools, among the program’s largest beneficiaries, received $3.3 million in 2013. Westerville schools received about $613,000, Hilliard schools got nearly $500,000, and Reynoldsburg schools received more than $270,000.

“Whatever your opinion of the Affordable Care Act, we should all agree that forcing schools to choose between laying off special education therapists that students depend on and increasing class sizes or reducing AP and elective classes for other students is wrong,” said Sen. Sherrod Brown, D-Ohio.

“Instead of forcing Ohio schools to cut services for our kids, let’s work together to lower costs and make health care work better for everyone.”

U.S. Rep. Pat Tiberi, R-Genoa Township, who voted for the House bill, justified Medicaid cuts to preserve the program.

“Right now, Medicaid is on a fiscal path that is unsustainable,” said Tiberi spokeswoman Olivia Hnat. “On its current track, in 10 years, Medicaid will cost $1 trillion every single year. This is not only a budget issue; it is a moral one. In the American Health Care Act, we aim to put this program on stronger financial footing so that it is available for our must-vulnerable patients and those in need over the long term.”


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Medicaid cuts could be bad news for special ed in Ohio