Email from National Association of School Nurses Federal Budget Law Enacts Historic Cuts to Medicaid, SNAP, and Public Education Funding – HR 1 On July 4, President Trump signed the 2025 Federal Budget Reconciliation bill (also known as the OBBBA/H.R. 1) into law, triggering the most significant cuts to Medicaid and SNAP in U.S. history. These sweeping changes are expected to have widespread and long-lasting effects—especially on families, schools, and communities that depend on a strong social safety net. While the full impact will unfold over several years, the law is already raising serious concerns among school nurses, educators, health care providers, and advocates for families and children. Key Impacts to Schools and Families Deep Cuts to Medicaid Will Harm Students and Schools According to the Kaiser Family Foundation (KFF), the bill cuts $1 trillion from federal Medicaid funding. It also changes how states can finance Medicaid and adds work requirements, which could result in 12–16 million people, including children, losing coverage. While the bill does not directly change the school-based Medicaid program, districts will still be affected. As families lose coverage, schools may see reduced Medicaid reimbursements for services like school nurses, mental health care, and special education—forcing many to cut programs, staff, or raise local taxes. SNAP Changes Will Reduce Access to School Meals Stricter eligibility requirements for food assistance will mean fewer families qualify for SNAP, and fewer children will be automatically eligible for free school meals. Programs like the Community Eligibility Provision (CEP), which allows high-need districts to offer universal free meals, will also be impacted. Many states may face difficult choices about how to maintain school nutrition programs with reduced federal support. Public School Funding Threatened by Vouchers The new law creates a national school voucher program, offering tax-deductible donations to private and religious schools—many of which are not held to the same federal education standards. This will drain enrollment and funding from public schools, destabilizing already under-resourced districts and limiting options for families—particularly those with students with disabilities. Immigrant and Refugee Families Face New Barriers The law bars immigrant and refugee families from accessing key health and social services while increasing federal funding for ICE detention and deportation. These changes will not only harm families directly but may also discourage many from seeking medical, educational, or social support out of fear. What Happens Next? This legislation rolls back decades of progress in public health and education. States will now bear the brunt of these cuts—and will be forced to decide how to respond. Without strong action, we could see: Rising uninsured rates among children and families Shrinking access to healthcare and nutrition Stalled momentum on school health and equity efforts NASN understands the fear and uncertainty this moment brings. We will continue working with our partners to advocate at every level—and to support school nurses, students and families navigating these unprecedented changes. New Medicaid Resources NASN is continually updating its Medicaid page with new resources to help school nurses stay abreast of any and all changes that occur on the federal and state levels. Check out more information on Medicaid. You can also watch some of our short videos about why Medicaid Matters on our YouTube playlist. Title VIII Nursing Workforce Reauthorization Act On May 23, the bipartisan, bicameral Title VIII Nursing Workforce Reauthorization Act of 2025 (S.1874/H.R.3593) was introduced in Congress. This legislation would reauthorize the Title VIII Nursing Workforce Development Programs through FY 2030. See Sen. Merkley's Press Release. Why Title VIII Matters With over 4.5 million Registered Nurses (RNs), Advanced Practice Registered Nurses (APRNs), and other nursing professionals nationwide, nurses make up the largest segment of the U.S. healthcare workforce—and are essential to delivering high-quality, evidence-based care across all settings. Title VIII Nursing Workforce Development programs are the federal government's primary tool for supporting nursing education, practice, recruitment, and retention. These programs strengthen the pipeline from entry-level nursing to advanced degrees, and support the institutions and faculty who prepare nurses for the front lines. This legislation will ensure a stable nursing workforce that will in turn provide a robust and sustainable pipeline of school nurses to guarantee students have equitable access to quality health care in schools. Strong, sustained funding for Title VIII is a direct investment in the future of healthcare—ensuring communities nationwide have access to safe, timely, and high-quality care. As our nation faces growing health challenges, continued support for these programs is more vital than ever. Please join NASN through our Action Center and urge your Senators and Representative to reauthorize the Title VIII Nursing Workforce Reauthorization Act of 2025. Trump Administration to Release Withheld School Funding The Trump administration will release over $5 billion in public school funding that had been frozen for nearly a month, following a programmatic review. The freeze, announced with little notice on June 30, delayed the expected July 1 disbursement and disrupted planning for summer programs and the upcoming school year. The withheld funds support critical K–12 programs, including teacher training, English language instruction, academic enrichment, and services for migrant students. Lawmakers from both parties had pushed for the release, and several states and districts had challenged the freeze in court. An earlier $1.3 billion portion had already been released. In total, nearly $7 billion is now being made available to schools, many of which serve the nation’s most vulnerable children. The funding pause caught school officials off guard, forcing some to consider delaying hiring or curriculum planning. With the full release now confirmed, districts are rushing to stabilize programs and staffing in time for the fall semester. Leading Medical Groups Sue HHS Over COVID Vaccine Rollback A coalition of prominent physician and public health organizations—including the American Academy of Pediatrics (AAP), the American College of Physicians, the American Public Health Association, and the Infectious Diseases Society of America—filed a federal lawsuit this week against Health and Human Services Secretary Robert F. Kennedy Jr. The lawsuit challenges Kennedy’s May 19 directive ending the federal government’s recommendation of COVID-19 vaccines for healthy children and pregnant people. The groups argue that this abrupt policy reversal violates long-established norms governing U.S. immunization policy and was made without citing new evidence, an emergency, or changing circumstances. In their filing, the organizations state that the directive directly contradicts a broad body of peer-reviewed research showing COVID-19 vaccines are safe and effective for both children and pregnant individuals. They warn the decision will undermine public confidence in vaccines and place healthcare providers in an impossible position. “These decisions are founded in fear and not evidence, and will make our children and communities more vulnerable to infectious diseases like measles, whooping cough, and influenza,” lawsuit says, AAP President Dr. Susan Kressly. She added, “our immunization system has long been a cornerstone of U.S. public health, but actions by the current administration are jeopardizing its success.” The plaintiffs are asking a federal court to block enforcement of the directive and restore COVID-19 vaccines to the CDC’s recommended immunization schedules. The anonymous plaintiff in the lawsuit is a pregnant woman who states she is at immediate risk for being unable to get the Covid-19 vaccine booster due to the Secretarial Directive, despite the high risk for exposure to infectious diseases from working as a physician at a hospital. Kennedy made the announcement in a May 27 video posted to X (formerly Twitter), flanked by FDA Commissioner Dr. Marty Makary and NIH Director Dr. Jay Bhattacharya—both known for opposing vaccine and mask mandates during the pandemic. In the video, the officials argued that there isn’t sufficient data to support continued vaccination for healthy children and pregnant individuals, and cited decisions by other countries that have rolled back similar recommendations. Kids Lose Under FDA Order for JUUL FDA authorized the marketing of five Juul e-cigarette products – the Juul device, Virginia Tobacco flavor Juulpods (3% and 5% nicotine concentration) and Menthol flavor Juulpods (3% and 5% nicotine concentration). You can find FDA's press release copied below. The list of total authorized e-cigarette products has been updated here. The decision to authorize the sale of Juul e-cigarettes risks a reversal of recent progress in reducing youth e-cigarette use. Juul played a central role in the youth vaping epidemic, with high school e-cigarette use surging from 11.7% in 2017 to 27.5% in 2019, largely due to its popularity. According to the 2024 National Youth Tobacco Survey, Juul remained in the top five most popular e-cigarette brands among U.S. youth. It is particularly troubling that the FDA authorized the sale of menthol-flavored Juul given the scientific evidence that menthol is a flavor that appeals to kids. Tobacco companies have a longstanding history of adding menthol to tobacco products to make them seem less harsh and more appealing to young people. Moreover, menthol enhances the effects of nicotine on the brain and can make tobacco products even more addictive. The FDA itself has found, in denying marketing applications for other menthol-flavored e-cigarettes, that “non-tobacco-flavored e-cigarettes, including menthol flavored e-cigarettes, have a known and substantial risk with regard to youth appeal, uptake and use.” You can find the Campaign for Tobacco-Free Kids statement on the decision here. Survey: How Much Do You Spend On Your Students? School nurses often go above and beyond for their students—including spending their own money. Please take a moment to answer this quick survey to help NASN better advocate for your needs. Take the Survey   In 2024, e-cigarettes were the most commonly used tobacco product among middle and high school students in the United States, according to CDC. Successful Advocacy Starts with Partnerships Effective advocacy doesn’t begin when a bill is introduced—it starts much earlier, in the quiet but powerful work of building relationships and shaping ideas. During Oregon’s 2025 legislative session, much of what made our advocacy successful happened while our proposal was still just a legislative concept. By the time it became a bill, we had already laid the groundwork with partners who understood why change was so critical. For years, school nurses in Oregon have expressed frustration about being supervised by non-nurse educators—people with little understanding of or respect for the standards of nursing practice. So much of our energy has gone into defending the integrity of our work—ensuring it aligns with evidence-based practice, the Oregon Nurse Practice Act, and the scope and standards of school nursing—that we’ve been left with less time to focus on caring for students. We assumed that solving this problem would require overhauling the entire system of school nursing supervision until a conversation with a parent of a student with significant disabilities changed everything. She asked, “Why can’t a school nurse who has ICU experience provide my daughter’s care?” I explained that, in Oregon schools, nurses often don’t control their caseloads or decide which care is direct versus delegated. With conviction, she responded, “We’re going to change that.” Over the next few years, the voices of nurses across Oregon grew louder. We heard story after story about nurses struggling to follow the nursing process while facing interference from administrators—and about talented professionals leaving the field because they couldn’t tolerate having their clinical judgment directed by non-nurses. Two key conversations reframed the issue for us. Melanie Bales, the NASN Director from Georgia, shared that she advises nurses to “Be a nurse first,” reminding us this is not just about supervision—it is about protecting the autonomy of nursing practice as defined in the Nurse Practice Act. NASN President Lynn Nelson pointed us to a statute in Washington State that offered a model. That became our starting point. With a legislative concept in hand, we worked closely with partners to shape the bill’s language and prepare it for success. The Oregon Department of Education and the Oregon Health Authority provided technical assistance so we were able to align our concept with existing health and education laws. Parent advocates introduced us to a nurse legislator who became our bill’s passionate sponsor, and legislators we had collaborated with in the past signed on as co-sponsors. Along the way, we engaged in difficult but productive conversations with the Coalition of School Administrators and the Oregon School Board Association. Both organizations initially resisted the idea of clarifying administrators’ limits in supervising licensed nurses, but through dialogue, we helped them understand that while they can oversee employment-related matters, directing clinical nursing practice crosses into practicing nursing without a license. The State Board of Nursing participated in those conversations to ensure everyone understood the intent and technical details of the Nurse Practice Act. The result of these collective efforts was that Hannah’s Law, which passed unanimously in both the House and Senate, has now been signed into law. It codifies nurses’ clinical autonomy and prohibits non-nurse administrators from directing the clinical practice of nursing. For school nurses, this is a restoration of professional integrity and a step toward better care for Oregon students. This experience highlights how important it is for school nurses to grow their advocacy skills and cultivate partnerships. There are many ways to begin: serve on boards, provide public comment on proposed administrative rules, or participate in Rule Advisory Committees for your state board of nursing. Engage with school health specialists in education and public health, and connect with those who analyze proposed legislation. Participate in district and state-level committees on topics where you have expertise, and reach out to others on committees or boards to build relationships and find shared goals. Advocacy is a skill, and like nursing itself, it grows stronger with practice and collaboration. State-by-State Legislation Kentucky  Kentucky Board of Nursing changes best practice protocols in schools Tennessee  Tennessee school district won't accept doctor's notes for absences Check Out a Full Legislative Tracking Chart View as Webpage Did you enjoy this email? National Association of School Nurses | 1100 Wayne Avenue Suite 925 | Silver Spring, MD 20910 US Unsubscribe | Update Profile | Constant Contact Data Notice