House Republican leaders say they have the votes to pass the American Health Care Act on Thursday, after Rep. Fred Upton (R-Mich.) added an amendment worth $8 billion over five years to ostensibly help shore up state pools for people with pre-existing conditions. But amid all the debate over what to do about pre-existing conditions, less attention has been paid to the bill's sweeping cuts to Medicaid — the AHCA will cut the federal health program for the lower-income and disabled by 25 percent, $880 billion over 10 years, and restructure it with per-capita caps on certain groups of beneficiaries.

House Speaker Paul Ryan (R-Wis.) touts ending Medicaid as an entitlement as one of the biggest accomplishments of the bill, along with cutting taxes for high-earners, but the deep cuts to Medicaid would also hurt students with disabilities across the country, The New York Times reports. "For nearly 30 years, Medicaid has helped school systems cover costs for special education services and equipment, from physical therapists to feeding tubes," reports Erica L. Green, but "under a little-noticed provision of the health-care bill, states would no longer have to consider schools eligible Medicaid providers, meaning they would not be entitled to reimbursements."

This week, a group of 50 organizations called the Save Medicaid in Schools Coalition warned in a letter to top lawmakers that the AHCA would force school districts to "ration health care for children," adding, "School-based Medicaid programs serve as a lifeline to children who can't access critical health care and health services outside of their school." It would at least leave states with a choice of filling the spending hole through higher taxes or reallocating resources, or cutting services for disabled students — which would run afoul of the federal Individuals With Disabilities Education Act.

"If I could have 10 minutes with President Trump, I could help him understand what we do, why it's important," Vickie Glenn, who oversees 2,500 special-needs students as Medicaid coordinator for Tri-County Special Education in Illinois, tells The New York Times. "If he understood, he would protect it, because this isn't Republicans and Democrats. It's just kids." She doesn't mind cuts to the program, "because Medicaid's been out of control," she added, but for special-needs students, "we have so many more demands. We're not in it making money. We're constantly in the hole." You can read more at The New York Times. Peter Weber