Charter schools, DEI, transgender athletes. These bills are still moving through the legislature
Here is a look at some of the education bills IndyStar is tracking that are still moving through the legislative process.
Lead author: Rep. Jeff Thompson, R-Lizton
What it does:This bill funds Indiana's government, health care programs like Medicaid, public K-12 schools and colleges for the next two years. Republican proponents say it's a "vanilla" budget that helps the state live within its fiscal means while funding key priorities such as removing the income cap for private school vouchers and a new workforce tax credit for employers. But Democratic opponents say the bill funds the wealthy at the expense of the poor, for example, by defunding the Dolly Parton Imagination Library program and failing to expand preschool.
Status: The bill passed the House by a 66-28 vote on Feb. 20 and now heads to the Senate.
More on the Dolly Parton library: Gov. Braun enlists first lady to save Dolly Parton Imagination Library after funding cut
Lead author: Sen. Linda Rogers, R-Granger
What it does: The bill would require all traditional public school districts, including Indianapolis Public Schools, to share property tax revenue with charter schools in their attendance boundaries, if 100 or more kids leave the traditional district for charter schools, starting in 2028.
Status: The bill passed out of the Senate by a 28-21 vote on Feb. 20 and now heads to the House.
More on this bill: Bill forcing schools to share property taxes with charters passes. But 40% of senators voted no
Lead author: Rep. Michelle Davis, R-Whiteland
What it does: This is virtually the same bill lawmakers passed in 2022, which banned transgender girls from participating in girls' K-12 sports. This year's bill extends that ban to collegiate athletics.
Status: The bill passed the House on Feb. 18 by a vote of 71-25. It now heads to the Senate.
Lead author: Sen. Stacey Donato, R-Logansport
What it does: The bill would allow public schools to hire or bring in on a volunteer basis religious chaplains, with an eye toward alleviating the burden on school counselors.
Status: Passed the Senate on Feb. 11 by a 32-16 vote.
More on SB 523: Indiana lawmakers revive bill to allow public schools to hire chaplains as councilors
Lead author: Rep. Bob Behning, R-Indianapolis
What it does: The bill aims to loosen restrictions for Indiana schools and education systems, including by nixing the education credential requirement for the Indiana secretary of education, changing the timing of when teachers are paid and removing certain training and professional development requirements.
Status: Passed the House by a 75-16 vote on Feb. 3. It now heads to the Senate.
Lead authors: Sen. Tyler Johnson, R-Leo, Sen. Gary Byrne, R-Byrneville
What it does: This bill bans all state spending on diversity, equity and inclusion initiatives — from training to diverse hiring initiatives — at state agencies, educational institutions and health profession licensing boards.
Status: The contents of this bill were amended into a different bill, Senate Bill 289, on the Senate floor on Feb. 4. That bill then passed the Senate on Feb. 6 by a 34-13 vote.
More on this bill: This anti-DEI bill is not law yet. State-funded colleges are ending programs already anyway
Lead Author: Sen. Liz Brown, R-Fort Wayne
What it does:The bill restricts government entities, including school districts and the Indiana Department of Child Services, from intruding on parental rights or keeping information from parents, unless there is a compelling governmental interest.
Status: Passed the Senate by a 44-5 vote on Jan. 27. It now heads to the House.
Indiana SB 143: Should DCS, schools be able to keep information from parents? Indiana Senate bill says no
Lead author: Rep. Bob Behning, R-Indianapolis
What it does: The bill prohibits a public school from expelling or suspending a student because they are chronically absent or habitually truant and expands the number of days for a school to hold an attendance conference about a student's absences from five days to 10. It also requires the Department of Education to establish best practices for student discipline on chronic absenteeism.
Status: Passed the House unanimously on Jan 30. A bill that similarly addresses absenteeism, Senate Bill 482, passed the Senate unanimously on Feb. 4.
Lead Author: Sen. Gary Byrne, R-Byrneville
What it does: The bill would require candidates running in school board elections to start including party identifications next to their names on the ballots.
Status: It passed out of the Senate on Feb. 17 by a 26-20 vote. It has now been referred to the House Committee on Elections and Apportionment.
Indiana Senate Bill 287: HSE, Carmel school board races were already political. This bill would add party affiliation
Contact IndyStar K-12 education reporter Caroline Beck at 317-618-5807 or CBeck@gannett.com. Follow her on Twitter (X): @CarolineB_Indy.
This article originally appeared on Indianapolis Star: DEI, charter schools. These bills are still alive at the Statehouse
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The Hill
14 minutes ago
- The Hill
Live updates: Hill Nation Summit explores Trump's term 6-month mark
Nearly six months into President Trump's second term, The Hill and NewsNation team up to host the inaugural Hill Nation Summit, a full-day bipartisan gathering in Washington, featuring leaders in government, business and policy. House Speaker Mike Johnson (R-La.), Homeland Security Secretary Kristi Noem, FDA Commissioner Dr. Marty Makary, White House senior counselor Peter Navarro, Leaders We Deserve founder David Hogg and more will be interviewed by Hill and NewsNation journalists. The event is scheduled to begin at 9 a.m. EDT. Watch it live here and follow along all day for updates from the summit. More than a week after the Justice Department issued a report on Jeffrey Epstein, the fallout persists. On Tuesday, Johnson broke with Trump and said Attorney General Pam Bondi needs to explain her statements regarding Epstein. Senate Republican leadership believes a vote on the White House's rescissions package is near, though with an agreement to strip PEPFAR cuts, the package will need to return to the House for a vote by Friday, the deadline for passage.


The Hill
14 minutes ago
- The Hill
Morning Report — Epstein saga circles back on Trump, Bondi
Morning Report is The Hill's a.m. newsletter. Subscribe here or using the box below: In today's issue: ▪ Epstein uproar splits GOP ▪ What to expect at Hill Nation Summit ▪ The Bidens aren't going quietly ▪ Ukraine waiting for weapons details The MAGA revolt over Jeffrey Epstein fractured President Trump 's defensive line on Tuesday. Fury within Trump's base about the Justice Department's handling of the Epstein investigation forced Speaker Mike Johnson (R-La.) to publicly split from the president to call for more 'transparency.' Some GOP lawmakers, who early this week dodged reporters' Epstein questions, are suddenly sounding amenable to holding hearings in response to base voters and conservative media influencers who fume about a possible administration cover-up. MAGA allies warn that disillusioned conservatives could stay home next year when the party is defending its majorities in the House and Senate, after Trump officials spent years vowing to expose the secrets of Epstein's 'client list,' which the administration now says is nonexistent. The president, who over the weekend accused 'selfish people' of obsessing about 'a guy who never dies,' on Tuesday praised Attorney General Pam Bondi while encouraging her to release 'whatever she thinks is credible' tied to the disgraced New York financier. OBJECTION, DEFLECTION: Trump has tried to ignore the MAGA eruption, leap past it and command his followers to get in line, and he's blamed the mess on past Democratic administrations and 'fake news.' None of those tactics have tamed the prolonged backlash and it's doubtful that 'more transparency' can quiet skeptics. The president may simply find a way to change the headlines. 'I don't understand why the Jeffrey Epstein case would be of interest to anybody. It's pretty boring stuff. It's sordid, but it's boring,' Trump told reporters Tuesday. 'And I don't understand why it keeps going. I think really only pretty bad people, including fake news, want to keep something like that going.' Bondi — criticized from the right and by Democrats eager to stoke a rare controversy that appears to be sticking to Trump like glue — is dug in. The attorney general on Tuesday rebuffed calls for her resignation. 'I'm going to be here for as long as the president wants me here, and I believe he's made that crystal clear,' she said. Johnson, who will appear at the Hill Nation Summit later today held by The Hill and NewsNation, said he's 'anxious to get this behind us.' ▪ The Hill: Rep. Thomas Massie (R-Ky.), with bipartisan support from Rep. Ro Khanna (D-Calif.), is leading a long-shot effort to force a House vote on releasing what he calls 'complete' Epstein files. ▪ The Hill: Rep. Lauren Boebert (R-Colo.) joins calls for Epstein files special counsel. Democrats on the House Judiciary Committee are pushing for a hearing to bring in Bondi and other top DOJ and FBI officials. Chairman Jim Jordan (R-Ohio), who will also appear at the Hill Nation Summit today, told The Hill on Tuesday he had 'confidence' in the president's team. Over in the Senate, Sens. Josh Hawley (R-Mo.) and Mike Lee (R-Utah) said they would support seeking testimony from longtime Epstein associate Ghislaine Maxwell, according to ABC News. Johnson told conservative podcaster Benny Johnson during a Tuesday interview that the attorney general should 'come forward' and explain her February remarks about Epstein files sitting 'on my desk.' Bondi now says those comments were misconstrued, and last week the Justice Department in a memo said its 'systematic review revealed no incriminating `client list.' There was also no credible evidence found that Epstein blackmailed prominent individuals as part of his actions.' Trump's daughter-in-law Lara Trump, the former head of the Republican National Committee and a potential GOP Senate candidate, joined in urging the White House to provide 'more transparency' around materials tied to Epstein, who died in jail while awaiting trial on federal sex-trafficking charges in 2019. 'I think that will happen. I know this is important to the president. He is frustrated,' she said during a podcast interview, adding she believed ' there will be more coming.' TUNE IN: The Hill and NewsNation's inaugural Hill Nation summit is happening in Washington throughout the day Wednesday. Newsmakers include Homeland Security Secretary Kristi Noem, Sen. Mark Warner (D-Va.), House Budget Committee Chair Jodey Arrington (R-Texas), White House trade adviser Peter Navarro and many more. ▪ Watch the Hill Nation Summit live starting at 9 a.m. ▪ Check out the summit agenda. ▪ Track insights and updates throughout the day on The Hill's live blog. SMART TAKE with BLAKE BURMAN I'll be interviewing Department of Homeland Security Secretary Kristi Noem and White House senior counselor for trade and manufacturing Peter Navarro at the Hill Nation Summit later this morning. Among the many reasons I'm looking forward to it is that the economy and immigration, the top two issues in the past election, remain among the top issues today. We saw President Trump have to deal with a rising inflation print yesterday, and he's now suggesting that only a few more trade deals might be struck before the end of the month. On immigration, questions remain on the administration's deportation actions. I'll highlight some of the major moments here tomorrow after the summit in Washington. Burman hosts 'The Hill' weeknights, 6p/5c on NewsNation. 3 Things to Know Today Trump will pull 2,000 National Guard members out of Los Angeles just a month after he ordered their deployment. Adelita Grijalva is projected to win the Democratic nomination to represent Arizona's 7th Congressional District. A former Pima County supervisor, she is the daughter of the late Rep. Raúl Grijalva (D-Ariz.). What causes obesity? A major new study offers some surprises. Leading the Day Speaker Mike Johnson (R-La.) will sit for an interview with The Hill's Emily Brooks during the inaugural Hill Nation Summit in Washington later today. Morning Report caught up with Brooks ahead of the interview. This conversation was edited for length and clarity. Morning Report's Kristina Karisch: You last interviewed Johnson six months ago. What has changed for the Speaker since then, and what topics will you be zeroing in on in your conversation today? Brooks: When I talked to Speaker Johnson in January, it was just at the beginning of Republicans starting their process on what would become the 'one big, beautiful bill,' and there was a big question about how much they could actually fit in that, and how Johnson himself would manage the extremely tight House GOP majority to get everybody on board to pass it. Now, that bill has passed through Trump's desk. Johnson met a lot of the deadlines that he set, defying expectations and worries that it would get held up. So, it's a nice bookend to that process. I'm curious to talk to him about how he did that. I think he's probably being taken a bit more seriously as a Speaker after this whole process. What are the biggest hurdles facing Johnson now as we move into appropriations season and the back half of the 119th Congress? Government funding and appropriations are going to be probably the biggest hurdles for Speaker Johnson and Republicans, just because they do have that super narrow majority. Then you have the issue that the Senate would, in most circumstances, need 60 votes to move forward on legislation. So [Johnson] needs [to put forward bills] that can not only get the support of his majority, but support from a couple of Democratic senators. Finding that balance, especially after they've passed such a major partisan bill, is going to continue to get him headaches. Johnson has been surprisingly successful in pulling legislative rabbits out of hats and passing these massive bills. Do you have a sense of his strategy? The thing that always comes up is that he is very much willing to hear out all corners of the conference. Sometimes that even frustrates some members … Warring factions come out of meetings with him having different impressions of what exactly the position or path forward is. Ultimately, it's proven to work for him, even if he has gotten some major assists from Trump in helping to push members across the finish line on some of these major votes. What does his relationship with Trump look like? We do know that Speaker Johnson and the president are in constant communication. They talk all the time. Speaker Johnson tells us all the time how much he's talking to the president. They're very in sync. He's a major tool for the administration on Capitol Hill to help them understand what is possible to move forward through that super narrow majority, and definitely a bridge from Capitol Hill to the White House. You're also talking today to Kevin McCarthy, Johnson's predecessor, whose Speakership ended very dramatically. What do you think distinguishes the two of them in their approaches? When you're comparing Kevin McCarthy and Mike Johnson, the first thing that you have to recognize is that they're facing very different environments. If Kevin McCarthy had come to power when Trump was still president and there was a Republican-controlled Senate, things might have turned out very differently for him. A lot of the rabble-rousers, or people who like to poke at leadership, have consistently decided to go along with what Republican leadership is doing despite criticism because they don't want to go against Trump. What else will you be tracking at the summit? The 'one, big beautiful' bill took up so much energy and focus, but there are a lot of other agenda items and fights brewing in Congress for the rest of this year and beyond. We're trying to find out more about exactly what Republicans on Capitol Hill could be planning for the rest of the year while we're here. When and Where The Hill Nation Summit featuring dozens of newsmakers is scheduled from 9 a.m. to 3:45 p.m. EDT in Washington … Lineup, live blog, video. President Trump will welcome Bahrain Crown Prince Salman bin Hamad Al Khalifa to the White House for a working visit at 11 a.m. Vice President Vance will travel to West Pittston, Pa., to promote provisions of the GOP's recently enacted One Big Beautiful Bill Act. The House convenes at 10 a.m. The Senate will meet at 10 a.m. Zoom In NO QUIET EXITS: Six months after former President Biden left the White House, he and his son Hunter Biden keep popping up in the news. The former president spoke with The New York Times about the pardons he approved at the end of his term for a story published Sunday. The interview sparked frustration among Democrats, many of whom argue he's taking the GOP bait at a time when the party is looking to go on offense. Hunter Biden, meanwhile, said in a new interview on former Democratic National Committee Chair Jaime Harrison 's new podcast, 'At Our Table,' that Democrats lost the November election to Trump because they weren't loyal to his father. 'You know what, we are going to fight amongst ourselves for the next three years until there's a nominee,' Biden said in an excerpt from the interview, which will air in an upcoming episode. 'And then with the nominee, we better as hell get behind that nominee.' 'And I will tell you why we lost the last election. We lost the election because we did not remain loyal to the leader of the party. That's my position,' he told Harrison, according to the excerpt. 'We had the advantage of incumbency. We had advantage of an incredibly successful administration, and the Democratic Party literally melted down.' ▪ The Hill: Hunter Biden hits back at Jake Tapper over 'chief of staff' allegations. CRYPTO: Trump said late Tuesday he reached a deal with most of the 12 House Republicans who derailed a procedural vote earlier in the day aimed at putting a trio of cryptocurrency bills on a path to consideration in the lower chamber, bringing the floor to a screeching halt. The chief concern among the hard-line contingent was the lack of a provision in the GENIUS Act that would block the creation of a central bank digital currency. The agreement, if it holds, could allow the House to move forward as early as Wednesday. ▪ The Hill: These 12 Republicans derailed House crypto legislation. TARIFFS: Republicans are worried about inflation and blowback from Trump's tariffs as the Aug. 1 deadline approaches. Consumer prices were up 2.7 percent in June on an annual basis, an anticipated number, the government reported on Tuesday. While the evidence in June was mixed on how much influence tariffs had over prices, there were signs that the duties are having an impact, particularly with food. Apparel and home furnishing prices rose, though vehicle prices fell, CNBC reports. ▪ CNN analysis: Trump continues to go after Federal Reserve Chair Jerome Powell, as his appointees lay out a framework that could allow the president to fire him with cause. The president on Tuesday announced a U.S. trade deal with Indonesia and said a trade agreement with India is getting closer. Trump also said his trip to Scotland at the end of the month will include a meeting with British Prime Minister Keir Starmer to fill in trade framework details announced previously. Trump's approach to setting tariff rates is causing anxiety in the business community. The president has sent two dozen tariff letters out, while leaving the door open to negotiations to lower those rates with trading partners such as the European Union. That's left the corporate world bracing for what next month could bring. 'People have built in that there will be some inflationary impact with tariffs at some point, not all of them can be absorbed by manufacturers and things like that, ' a GOP lobbyist said. 'But the problem becomes now you're compounding that with this herky-jerky thing that creates instability.' ▪ CBS News: The administration said that it would impose a 17 percent tariff on Mexican tomatoes. Economists warn that it could drive up prices at the supermarket. ▪ Politico: The European Union is looking at targeting billions in U.S. goods in a second round of trade countermeasures. RECISSIONS: Senate Republicans on Tuesday narrowly cleared a key procedural hurdle on the path to claw back more than $9 billion in funding previously authorized by Congress for foreign aid and public broadcasting. Vice President Vance had to break the 50-50 tie vote after three Republicans — Sens. Lisa Murkowski (Alaska), Susan Collins (Maine) and Mitch McConnell (Ky.) — voted against a motion to pass the package out of the Senate Appropriations Committee, allowing the full upper chamber to advance to consideration of the package. Congress has until Friday to pass the legislation under the special rescissions process that allows the Senate to approve the funding cuts with a simple majority vote, bypassing expected Democratic opposition. The legislation passed the House last month. On Tuesday, White House budget chief Russell Vought said the administration was on board with a substitute amendment to the rescissions package that would exempt the President's Emergency Plan for AIDS Relief (PEPFAR), the global initiative launched to combat AIDS, from cuts. ▪ The Hill: Senate Republicans are hoping to avoid a repeat of the tax bill when the rescissions package hits the floor in the coming days by trying to limit side deals. IN OTHER NEWS: ▪ The Hill: Senate Judiciary Committee members face a tough vote today to advance Deputy Attorney General Emil Bove 's nomination for a lifetime appointment to the 3rd Circuit Court of Appeals. A whistleblower alleges Bove knowingly skirted the law and a federal judge's orders. ▪ The Hill: New York City mayoral candidate Zohran Mamdani is taking steps to court Washington's political class. The meetups come as Democrats grapple with how the democratic socialist fits into the party that's been soul-searching after 2024 losses. Elsewhere UKRAINE: Ukraine is waiting for further details on 'billions of dollars' in U.S. military equipment promised by Trump on Monday, amid confusion as to how many Patriot air defense systems will be sent to Kyiv. Trump said an unnamed country was ready to immediately provide '17 Patriots' to Ukraine as he said a 'very big deal' had been reached for NATO allies to buy weapons from Washington and then ship them to Ukraine. But Maj. Gen. Vadym Skibitsky, the deputy head of Ukraine's military intelligence agency, said it was unclear what the president meant. 'We don't know exactly,' he said, adding Ukraine was grateful for the assistance. Despite Trump's assistance for Ukraine and its president, Volodymyr Zelensky, he still reportedly believes Russian President Vladimir Putin has the upper hand in the conflict. 'The president's view is Russia is going to win, it's a matter of how long it takes,' a senior White House official told Politico. 'Russia has the bigger economy, has the bigger military, has more than enough bodies to throw into the meat grinder, and just doesn't care. And although they are making slow progress, they are still making progress. The president just wants to stop the killing.' But even as Trump ups the pressure on Moscow, going against the isolationist wing of the MAGA movement, he is insisting that this latest move aligns with his 'America First' strategy. MAGA firebrands, including Rep. Marjorie Taylor Greene (R-Ga.) and former Trump strategist Steve Bannon, are among those who have criticized the decision, with Bannon telling his podcast listeners that Ukraine is a 'European war.' ▪ BBC: Trump said Tuesday that Ukraine should not target Moscow with strikes, after the Financial Times reported that the president had privately encouraged Ukraine to escalate attacks on Russia. ▪ The New York Times: Here's what we know about the weapons deal. ISRAEL: An Israeli plan to move hundreds of thousands of already uprooted Palestinians to a so-called humanitarian city in Gaza has led to conflict between politicians and military officials. But Israeli officials said there is not yet a practical plan in place. Opposition critics have denounced the proposal, with some likening the suggested site to a 'concentration camp,' which could lead to ethnic cleansing in the enclave. The divide comes as Israeli Prime Minister Benjamin Netanyahu's government suffered a serious blow on Tuesday when an ultra-Orthodox party announced it was bolting the coalition. His rule isn't immediately in jeopardy, but the exit could set the stage for a months-long crumbling of the government and complicate efforts to halt the war in Gaza. ▪ PBS NewsHour: The European Union is seeking updates from Israel on implementation of a new deal to deliver humanitarian aid to Gaza. ▪ The New York Times: Israel intervened in sectarian violence in Syria and attacked the Iran-backed Hezbollah militia in Lebanon. ▪ The Associated Press: Francesca Albanese, the United Nations' special rapporteur for Gaza and the West Bank, said nations around the world should take concrete actions to stop what she called the 'genocide' in Gaza. Secretary of State Marco Rubio previously announced sanctions on Albanese over what he called her 'anti-Israel' stance. Opinion Public media can be a lifeline. Gutting it hurts everyone, The New York Times editorial. Soft power for a tough world, by William H. McRaven, opinion contributor, The Washington Post. The Closer And finally … 🦢 'All up!' It's Swan Upping season in London. One of King Charles III 's lesser-known titles is Seigneur (or Lord) of the Swans. According to ancient lore, the monarch owns all members of the mute swan species found in Britain's open waters. And those swans must be counted — in an annual five-day swan census. Every year, a team of oarsmen are tasked with finding the swans on a stretch of the Thames. When a family is spotted, they shout, 'All up!' and the boats quickly surround the birds, mark them and check for signs of disease or injury.


Medscape
14 minutes ago
- Medscape
What Does the New US Budget Law Mean for Physicians?
Physicians are still assessing the impact of the budget and policy package passed by Congressional Republicans and recently signed into law by President Donald Trump. The legislation makes the largest cuts to Medicaid in its history, eliminating about $1 trillion over 10 years and establishing a work requirement that could force many recipients off the program over bureaucratic hurdles. Nearly 12 million Americans are expected to lose health coverage over 10 years as a result, according to the Congressional Budget Office. Millions more will be affected by the law's ending of certain health insurance subsidies created under the Affordable Care Act. Here's what physicians should know: Medicare Pay Bump In the near term, physicians will see a 1-year 2026 temporary increase of 2.5% in a rate used in determining Medicare's payments to clinicians. Despite that bit of good news, the budget package will make it more challenging to practice medicine, Bobby Mukkamala, MD, president of the American Medical Association (AMA), told Medscape Medical News in an interview. Clinicians, hospitals, and medical groups are likely to have to provide more uncompensated care to the uninsured. 'When it comes to healthcare in this country and the training for healthcare in this country, I don't see anything to be happy about,' Mukkamala said. Medicaid patients made up about 17% of the average physician's caseload in 2016, according to the AMA's Physician Practice Benchmark Survey. But pediatricians, with the largest average Medicaid patient share of any specialty at nearly 35%, could see a bigger reimbursement hit, depending on whether they are on salary or not. Psychiatrists and emergency medicine physicians also have above average Medicaid patient shares (26% and 22%, respectively). Internists reported the lowest Medicaid patient share at just under 12%. New Med Student Loan Limits The new law also limits federal loans for professional programs including medical and dental school to $50,000 a year with a total cap of $200,000. The average medical school debt tops $234,000, according to an Education Data Initiative report, but tuition and living expenses for private schools can top $87,000 per year. The Association of American Medical Colleges (AAMC) said in a statement that the budget package's elimination of the Grad PLUS loan program 'will affect many prospective medical and other health profession's students and worsen the nation's persistent doctor shortage.' AAMC leaders said they were 'dismayed' by 'massive cuts to Medicaid and changes to state health insurance marketplace exchanges that will lead to tens of millions of people losing much-needed healthcare coverage.' Anders Gilberg, senior vice president for government affairs for the Medical Group Management Association, said the newly cleared bill 'paints a grim future for America's physician practices by stripping healthcare coverage from millions of Americans.' People who lose healthcare coverage 'will still find care in our US healthcare system,' Gilberg said, but 'medical groups and hospitals will be left picking up the enormous tab.' 'With these historic Medicaid cuts, dedicated physicians and medical practices committed to providing care in our country's most underserved areas will face growing financial burdens as they are forced to offer more and more uncompensated care,' he said. A Boost for Direct Primary Care The budget package also for the first time allows patients to use their Health Savings Accounts to pay for monthly fees charged by direct primary care providers, which may include office visits but not major procedures, lab tests, or prescription drugs. Monthly fees of up to $150 ($300 per couple) will be allowed and will be tied to inflation going forward. The provision is seen as a win for the growing direct primary care movement. Uninsured Concerns It's not yet clear how many adults will eventually lose health coverage due to the implementation of the new law. The Congressional Budget Office had estimated that 11.8 million fewer people would have had health insurance in 2034 if an earlier Senate version of the bill were adopted. Belinda R. Avalos, MD, president of the American Society of Hematology said in a statement that nearly half of people living with sickle cell disease are covered under Medicaid or the Children's Health Insurance Program. 'It is profoundly disappointing that the Senate and House have voted to adopt the devastating cuts to Medicaid outlined in this bill,' Avalos said. 'These cuts recklessly endanger the health of millions of Americans, including those living with complex, life-threatening blood disorders.' In a statement, the American College of Rheumatology (ACR) said it also was 'disappointed that Congress has advanced legislation that could impact patients' access to Medicaid and limit providers' ability to care for vulnerable patients.' 'We encourage leaders in Washington to support measures that expand access to care and coverage for patients, rather than displacing the estimated 11.8 million Americans whose insurance could be at risk,' ACR said.