Yesterday, the U.S. Senate passed a federal reconciliation bill that would slash more than $1 trillion in healthcare and other essential services, including deep cuts to Medicaid, SNAP benefits, and housing assistance. This is one of the largest attacks on the safety net in decades—and we have very little time left to stop it.

The bill is now back with the heading back to the House of Representatives for final approval—with a vote expected as early as this morning. 

PLEASE take action TODAY!

• Call your Representative at 1-855-245-3682 and say:

“Vote NO on the current federal budget bill. Protect Medicaid, SNAP, and housing. Don’t leave millions of Americans without life-sustaining care.”

Custom Letters for New York Districts:

New York’s Behavioral Health Advocates coalition has created custom template letters for organizations and individuals in New York’s Republican House districts. These include district-level data on Medicaid enrollment and behavioral health impact, along with infographics to strengthen your outreach.

If you or your organization is located in one of these districts:

1. Download the template letter for your representative (SEE BELOW including the chart at the end that contains email addresses for these representatives.
2. Add your agency’s info where indicated, or remove those lines if not applicable.
3. Use your letterhead and send. 

We cannot let this bill become law. The proposed cuts will strip essential services from millions of low-income children, adults, families, and people with disabilities. They will force hospitals to close, increase homelessness, and widen health disparities across New York and beyond.

This is our moment to be heard. Please take a few minutes now to make your voice count—and share this action widely.

If you have any questions or need help accessing the materials, don’t hesitate to reach out. See the attached infographics as well as the chart of New York Representative Districts and contact links below to facilitate our advocacy efforts today!

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The Senate-passed bill would cause 11.8 million people to become uninsured, compared with 10.9 million under the House measure, according to the nonpartisan Congressional Budget Office.

The healthcare sector opposes the legislation virtually uniformly.

These are the major healthcare policies that could jeopardize the July 4 deadline and force Trump and the GOP-led Congress to make further amendments to the One Big Beautiful Bill.

Medicaid cuts

Perhaps foremost among Johnson’s challenges is soothing swing district lawmakers who were already concerned about the roughly $800 billion in Medicaid cuts the House OK’d. The Senate version would cut the program by at least $940 billion over 10 years, according to a CBO analysis issued Sunday that doesn’t include last-minute changes to the bill.

Sixteen House Republicans wrote Senate Majority Leader John Thune (R-S.D.) last week urging him to pull back on the Medicaid cuts.

“Protecting Medicaid is essential for the vulnerable constituents we were elected to represent,” Rep. David Valadao (R-Calif.) and colleagues wrote. “We cannot support a final bill that threatens access to coverage or jeopardizes the stability of our hospitals and providers.”

A key objection is that the Senate went further than the House in curtailing provider taxes states use to help cover their Medicaid expenses and trigger higher federal funding along with limits to state-directed payments they employ to dictate provider reimbursements to Medicaid managed care companies.

While the House bill would tighten the rules around those policies, the measure merely would freeze provider taxes and bar states from creating new ones. The Senate legislation would force states to reduce the taxes so they represent no more than 3.5% of a provider’s net patient revenue, down from the 6% cap currently in place.

“We’re going to debate it, and see which way it goes,” House Energy and Commerce Committee Chair Brett Guthrie (R-Ky.) said during the Rules Committee session Tuesday.

The federal budget

A group of more conservative Republicans are upset about the Senate bill’s ramifications for the budget. The lower chamber’s measure would add about $2.4 trillion to the national debt, compared with $3.3 trillion under the upper chamber’s legislation.

Rep. Ralph Norman (R-S.C.), who sits on the Rules Committee and belongs to the conservative Freedom Caucus, declared he opposed the Senate bill after supporting the House version.

“What the Senate did is unconscionable. What they did to our bill was unconscionable,” Norman said Tuesday. “I will vote against it here. I will vote against it on the floor,” he said.

Rep. Chip Roy (R-Texas), another hardliner on the Rules Committee and a Freedom Caucus member, made a similar vow. “My colleagues in the Senate failed us,” he said Tuesday.

Johnson can only afford to lose a handful of GOP lawmakers. In May, the bill passed 215 – 214, with Rep. Dr. Andy Harris (R-Md.), who chairs the Freedom Caucus, voting “present” and Rep. Andrew Garbarino (R-N.Y.), who signed the Valadao letter, missing the vote.

Johnson relied on Trump to push the bill over the line, and likely will need to again.

Process concerns and other issues

While the budget and Medicaid are the top issues dividing House Republicans, several other matters could drive opposition.

For example, while the House rolled back green energy policies and tax breaks, the Senate cut even deeper, and some members in conservative states that benefit from billions of dollars in green energy investment have raised objections.

Process could also be a stumbling point.

Roy highlighted how little anyone understood the Senate bill, which was being modified almost until it passed. He asked Guthrie and other committee chairs testifying before the Rules Committee whether they’d read the new measure before arriving to explain it. All of them said they had not finished.

Several House Republicans were caught unaware by provisions in their own bill, and could insist they have time to assess the latest version.

Republicans were expected to meet Tuesday and Wednesday to work out a path forward. If too many find the Senate’s work unpalatable, they would have to amend it, which would require it to go back to the Senate, instead of the president.

Norman predicted the House would rework it, and make it more like the House-passed bill.

Sen. Lisa Murkowski (R-Alaska), whose support after securing funding for rural healthcare providers was decisive, said she wanted the House to give the Senate another go.

“My hope is that the House is going to look at this and recognize that we’re not there yet,” Murkowski said Tuesday. “I would hope that we would be able to actually do what we used to do around here, which is work back and forth between the two bodies to get a measure that’s going to be better for the people in this country.”

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The New York State Department of Health (NYS DOH) is seeking feedback from Medicaid member advocates / consumer groups, member representatives, health care and behavioral health providers, and health-related social need (HRSN) service providers on their experience with the Social Care Network (SCN) program. DOH will address your feedback and any questions you have via two upcoming SCN program webinars catered to provider groups and advocate and consumer groups. Your insights and feedback will help the SCN program better meet the needs of Medicaid members.

Webinar:

New York State Department of Health “Social Care Networks: Opportunities for Provider Participation and Impact” Webinar on July 14, 2025

Program Survey:

This webinar will be informed by participants questions and concerns. To provide input, take the five-minute Social Care Network (SCN) Program Survey:

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Attorney General Letitia James in suing the Federal Government for unsustainable cuts to low income and rural schools in regard to youth mental health funding. 

Attorney General James Sues Trump Administration for Slashing Youth Mental Health Funding

Department of Education Cancelled Over $1 Billion in Bipartisan Mental Health Funding for Students in Low-Income and Rural Communities, Citing “DEI” 
AG James and Coalition Urge Court to Reinstate Grants, Prevent ED from Making Further Harmful Ideological Cuts 

July 1, 2025

NEW YORK – New York Attorney General Letitia James and 15 other attorneys general sued the U.S. Department of Education (ED) and Secretary of Education Linda McMahon for unlawfully terminating more than $1 billion in bipartisan federal funding for school-based mental health services. Attorney General James and the coalition are challenging ED’s abrupt decision to discontinue funding for two mental health grant programs – the Mental Health Service Professional Demonstration Grant Program (MHSP) and the School-Based Mental Health Services Grant Program (SBMH) – which Congress created in response to the worsening youth mental health crisis and a series of tragic school shootings, including in Parkland, Florida and Uvalde, Texas. The attorneys general argue that ED’s terminations are unconstitutional and ideologically driven, and are urging the court to reinstate the funding and protect the critical youth mental health infrastructure schools have built under these programs.

“By cutting funding for these lifesaving youth mental health programs, the Department of Education is abandoning our children when they need us most,” said Attorney General James. “These grants have helped thousands of students access critical mental health services at a time when young people are facing record levels of depression, trauma, and anxiety. To eliminate these grants now would be a grave disservice to children and families in New York and nationwide, and my office is fighting back to preserve these much-needed programs.”

“SUNY is grateful to Attorney General James for protecting New Yorkers, including critical resources for mental health support,” said SUNY Chancellor John B. King Jr. “At a time when school-based mental health services are more important than ever, SUNY is proud that our campuses play a vital role in training mental health providers and we will vigorously defend this important work.”

In 2018, following the mass shooting at Marjory Stoneman Douglas High School in Parkland, Congress established and funded MHSP to address a shortage of mental health professionals in high-need public schools. Two years later, Congress expanded these efforts with SBMH, which provided funding to help schools hire, train, and retain school-based mental health staff. In the wake of the devastating 2022 shooting at Robb Elementary School in Uvalde, Congress dramatically increased funding for both programs, appropriating more than $100 million annually to each program through 2026 and requiring ED to submit detailed spending plans and biweekly updates. Each program was designed as a five-year initiative, with the goal of placing 14,000 new mental health professionals in schools, particularly those in low-income and rural areas.

In the lawsuit, the attorneys general highlight the broad, bipartisan support behind these programs. As Republican Texas Senator John Cornyn noted, Congress “crafted this landmark law with a simple purpose: to reduce violence and save lives.” He explained that the law contains “commonsense measures to improve how our schools address mental health,” noting that “too often, adolescents with untreated mental health conditions become the very same perpetrators who commit acts of violence.”

Attorney General James and the coalition emphasize that these programs have already demonstrated measurable success. In the first year alone, nearly 775,000 students received mental or behavioral health services. More than 1,200 school-based mental health professionals were hired and 95 percent retained. Student wait times dropped by 80 percent. Grantees reported a 50 percent reduction in suicide risk at high-need schools, lower absenteeism and behavioral incidents, and stronger student-staff relationships.

Despite these successes, on April 29, 2025, the administration abruptly notified dozens of grantees that their funding would be discontinued, claiming that these program were no longer aligned with “current administration priorities.” The boilerplate notices included vague justifications with no specific findings or performance issues. In statements to Congress and the media, ED acknowledged that it targeted grants for discontinuation based on the programs’ diversity, equity, and inclusion (DEI) goals, despite the fact that such efforts were required under longstanding federal law and were part of the announced criteria used to evaluate and award the grants. 

As a result of the administration’s decision to discontinue mental health funding, Attorney General James and the coalition assert that, starting this fall, public schools nationwide will no longer reliably be able to offer critical mental health services. The attorneys general argue that if allowed to move forward, these terminations will force the layoffs of hundreds of school-based mental health professionals, abruptly end services for thousands of vulnerable students, dismantle graduate training pipelines that were helping to address nationwide shortages, and destroy projects that have been years in the making.

New York stands to lose at least $19 million in previously approved funding as a result of these cuts, including over $7.6 million for the State University of New York (SUNY) system. Unless the terminations are reversed, SUNY Binghamton will be forced to pull mental health professionals from schools serving more than 9,000 rural students, laying off 10 full-time staff and several part-time employees and graduate assistants. SUNY Buffalo would be forced to end a fellowship program training school social workers to serve students in Western New York, jeopardizing care for an estimated 3,000 students. Several New York school districts and private institutions have also had their funding discontinued, jeopardizing mental health services for students in the Bronx, Queens, Brooklyn, Long Island, Hudson Valley, Finger Lakes, Mohawk Valley, Central New York, and other communities throughout the state.

Attorney General James and the coalition argue that the cancellation of this funding is both unlawful and unconstitutional, as it undermines Congress’ authority and equity directive and violates the Administrative Procedure Act (APA) because of the lack of notice. The attorneys general also contend that the administration breached the grant agreements and violated federal regulations that govern the continuation of grant awards. Under these regulations, once a multiyear grant is awarded, the decision to continue funding must be based on the grantee’s performance. In this case, ED failed to offer any evidence that the grantees failed to meet performance standards and instead applied an ideological litmus test after the fact, leaving schools and students to suffer the consequences.

The attorneys general are asking the court to declare these grant terminations unlawful, reinstate the funding for the full intended term of the awards, and prevent ED from imposing similar ideological conditions moving forward.

Joining Attorney General James in this lawsuit are the attorneys general of California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, New Mexico, Nevada, Oregon, Rhode Island, Washington, and Wisconsin.