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Welcome to a special midweek message from the North Dakota Democratic-NPL Insider, a newsletter that features regular updates about upcoming Dem-NPL events, legislative happenings, and news that affects North Dakotans!
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North Dakota’s Children vs. The Big Beautiful Bill
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Today's Midweek Message is from District 24's Dr. Steven L. Johnson
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As someone who has spent nearly five decades in public education—and 32 years serving on the South Valley Special Education Multi-District Unit Board—I’ve seen firsthand how essential Medicaid is to the health, education, and dignity of rural children with special needs. I’ve worked beside parents fighting for their child’s right to attend school with the supports they need and helped districts navigate the complexity of providing mandated services with limited resources.
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Medicaid isn’t a handout—it’s a foundation. It allows a speech therapist to serve students in their hometown. It helps a child with autism remain in their neighborhood school instead of traveling hours for care. It ensures school-based mental health support is available where no private providers exist.
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For those of us working in small towns and rural schools, the House-passed “One Big Beautiful Bill” raises deep concerns about who gets left behind.
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Those who supported and passed the bill assure us that it won’t hurt children, families, or people with disabilities. But independent, nonpartisan research tells a different story.
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The Congressional Budget Office estimates that the bill would reduce Medicaid funding by $793 to $880 billion over the next decade, resulting in up to 10.3 million Americans losing coverage due to work requirements, provider payment limits, and stricter eligibility checks (CBO, 2024; KFF, 2025). These policies may be framed as “efficiency,” but in practice, they risk disrupting essential services in schools across rural America.
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Here in North Dakota, 112 public schools submitted more than 151,000 Medicaid claims in 2023, supporting over 5,000 students with special needs and bringing in $8.7 million in reimbursements (ND SEEC & Child Care Aware, 2025). These funds help pay for school-based speech and occupational therapy, transportation aides, behavioral health support, and more. Without them, schools are forced to either reduce services or absorb the cost.
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If just 20% of that funding were lost—a conservative estimate given the bill’s structural changes—districts across the state would face a $1.74 million shortfall. That could mean cutting special education staff, scaling back therapy hours, or placing a larger burden on local taxpayers to maintain federally required services under the Individuals with Disabilities Education Act (IDEA).
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The concern doesn’t end with schools. The American Hospital Association warns that this legislation could result in 1.8 million rural Americans losing Medicaid coverage and $50.4 billion in funding cuts to rural hospitals over the next decade (AHA, 2025). When rural health systems suffer, schools feel the ripple effects—fewer providers willing to partner with districts, longer waits for services, and higher costs for care.
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The Commonwealth Fund projects that combined cuts to Medicaid and SNAP would result in 1.22 million job losses, especially in states with small, rural populations like ours (Commonwealth Fund, 2025). That’s not just an economic issue—it’s a direct threat to the stability of rural communities and the schools at their center.
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And we’ve seen how this plays out. When Arkansas piloted Medicaid work requirements in 2018, 18,000 people lost coverage in just seven months, most due to paperwork errors, not ineligibility (Arkansas DHS, 2019). Rural families, often without broadband or access to caseworkers, are most vulnerable to this kind of administrative churn.
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Those of us who serve in rural education know that every child counts and every dollar matters. These aren’t abstract policy debates—they’re choices that affect whether a child receives needed therapy or whether a rural school can keep its special education unit staffed.
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For more than three decades, I’ve worked to protect the rights of every student—especially those whose needs are greatest and voices are quietest. If this legislation moves forward, it’s our rural children with disabilities who stand to lose the most.
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The bill’s name may be “beautiful,” but there is nothing beautiful about shifting the cost of essential services onto families and communities who can least afford it. North Dakotans believe in responsibility, fairness, and taking care of our neighbors. Let’s not lose sight of that.
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We must stand up—for our children, our schools, and our communities—before more damage is done.
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North Dakota SEEC & Child Care Aware, “Childhood Supports At A Glance,” 2025
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Congressional Budget Office, “Analysis of House Medicaid Reforms,” 2024
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Kaiser Family Foundation (KFF), Medicaid Budget and Enrollment Tracker, 2025
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Center on Budget and Policy Priorities, “House Budget Plan Medicaid Impact,” 2025
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American Hospital Association, “Impact of Medicaid Cuts on Rural Health,” 2025
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Commonwealth Fund, “Projected Economic Effects of Cuts to Medicaid and SNAP,” 2025
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Arkansas Department of Human Services, Medicaid Work Requirement Evaluation Report, 2019
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The Century Club supports our year-round work to build party infrastructure supporting candidate recruitment, local district and regional leadership, issue-based education, and tools for Dem-NPL success.
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Help us elect great Democrats up and down the ballot!
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The North Dakota Democratic-NPL is launching a new grassroots program called “Neighbor to Neighbor” where volunteers will connect with voters in your community to elect Democrats up and down the ballot. As a volunteer, you will be responsible for connecting with voters in 25 homes in your neighborhood or friends and family to help elect Democrats up and down the ballot about 3-4 times this year.
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Grassroots organizers are the lifeblood of the Dem-NPL! Sign up to volunteer with the Dem-NPL!
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