Photo taken over a school bus driver’s shoulder showing a school bus dash board. Photo by Taylor Ekbatani Cover design by Kimber Horne
Our first issue of 2026 brings the focus back to transportation of students with special needs and disabilities. Learn more about leveraging camera technology for student safety and driver training, Medicaid reimbursement management, the considerations of using non-yellow school bus vehicles for student transportation and the details on new securement technology for students with disabilities and how to train staff to use it correctly. Also read articles on targeting sexual assault onboard school buses and the multi-faceted approach needed to build and retain student transportation teams that are prepared for the wide variety of student needs.
Find more information about our upcoming 2026 conferences in the magazine as well as a recap of the 2025 TSD Conference!
Navigating the Complexities
The arduous task of tracking students and routes for Medicaid reimbursement can be off-putting. However, software companies are highlighting the benefits of how technology can help with documenting and reporting.
Smaller Options
Switching to alternative transportation vehicles like vans and SUVs for students with disabilities is beneficial in some circumstances, but at what cost?
Secure & Ensure
As securement devices for students with disabilities become more specialized, ensuring transportation staff are trained in securing them properly inside the school bus is a top safety element.
Special Reports
Eagle Eye on Student Transportation Safety
Leveraging camera technology can offer a host of safety solutions, from identifying student behavior issues to detailing driver performance behind the wheel.
Unauthorized immigrants are not eligible for federally or state-funded health coverage in Wisconsin.
That includes Medicaid, Medicare and the Children’s Health Insurance Program (CHIP), and coverage purchased through the Affordable Care Act (Obamacare) marketplaces.
Unauthorized immigrants also are not eligible for Wisconsin Medicaid or BadgerCare Plus.
Fourteen states, including Illinois and Minnesota, use state Medicaid funds to cover unauthorized immigrants, but Wisconsin does not.
Democratic Gov. Tony Evers on Dec. 5 vetoed a Republican-backed bill that would have banned public money from going toward health care coverage for unauthorized immigrants.
Republicans said the bill was meant to be pre-emptive.
On Dec. 10, Republican U.S. Rep. Tom Tiffany, who is running for governor in 2026, incorrectly said Evers’ veto allowed unauthorized immigrants “to continue to get taxpayer-funded health care.”
When Evers vetoed the bill he criticized it for “trying to push polarizing political rhetoric.”
This fact brief is responsive to conversations such as this one.
Abortion-rights advocate Kristin Hady helps a car navigate past protesters toward A Preferred Women’s Health Center of Atlanta in Forest Park, Georgia, in August 2023. Independent clinics are facing fresh challenges, and at least 23 more closed this year, bringing the total to 100 since the Dobbs decision. (Photo by Ross Williams/Georgia Recorder)
When Wisconsin Planned Parenthood clinics temporarily paused abortion services in October because of a new law halting federal Medicaid reimbursements, patients turned to the state’s two independent clinics for care.
Demand at Affiliated Medical Services in Milwaukee quadrupled, according to clinic director Dabbie Phonekeo.
“It happened all of a sudden. We were all scrambling to figure out what we needed to do and how we were going to accept all patients,” Phonekeo said.
The staff secured additional funding to meet need before Wisconsin’s Planned Parenthood clinics resumed abortions, adapting under a law that bans certain reproductive health care providers from receiving federal funding until July 2026.
“This was a reminder of why it’s so important to have independent clinics and abortion access overall,” Phonekeo said.
At least 23 independent clinics have closed this year, according to a report released Tuesday by Abortion Care Network, compared with 12 last year.
Most were in states with abortion-rights protections, the report found.
Independent providers face less recognition than Planned Parenthood and ongoing barriers to funding. Donations to abortion clinics and funds have waned, leading to more out-of-pocket costs for patients, States Newsroom reported last year.
Independent clinics provide 58% of all abortions nationwide, while Planned Parenthood provides 38%, hospitals 3%, and 1% occur at physicians’ offices, according to the latest Abortion Care Network findings.
Medication abortion, allowed during the first 10 weeks of pregnancy, has been a focus of abortion-rights advocates and opponents this year. But independent clinics are more likely to offer legal procedural abortions after that.
More than 60% of all U.S. clinics that offer abortion care after the first trimester are independent, 85% that provide abortion at 22 weeks or later are independent, and all clinics that perform the procedure after 26 weeks are independent, according to the report.
“While both medication and in-clinic abortion are safe and effective, people may need or prefer one method over another,” the report states. “This is especially true for patients for whom it’s not safe or feasible to terminate outside the clinic — including those experiencing intimate partner violence, minors without support at home, people experiencing homelessness, and patients who cannot take time off from work or caretaking.”
The latest clinic closures come more than three years after the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision forced many to cease operations: 100 independent clinics closed between 2022 and 2025.
Affiliated Medical Services in Wisconsin is one of the few independent abortion providers that was able to reopen after closing the day the nation’s highest court overturned federal abortion rights on June 24, 2022.
The clinic reopened in March 2024 a few months after a Wisconsin judge ruled that a 19th century abortion ban was invalid, Wisconsin Examiner reported.
Phonekeo said people were initially hesitant to book appointments at the clinic.
“Most of our patients that we saw had asked, ‘Is this legal? Am I going to go to jail if I have an abortion today? Can we do this in Wisconsin?’ So I think a lot of patients were still afraid to be seen,” she said.
Some anti-abortion groups have urged the Trump administration to disqualify Planned Parenthood as a federal vendor, States Newsroom reported in November.
Nearly 50 Planned Parenthood clinics closed this year due to federal health officials’ cuts to Title X and Medicaid. At least 20 closed since a federal “defunding” provision that halts Medicaid funds for reproductive health care providers that offer abortion and received more than $800,000 in fiscal year 2023 took effect, according to a tally released on Nov. 12 by the national organization.
Some of the clinics that closed did not offer abortion. And under the law, federal funding only covers abortions in extreme circumstances, so the Medicaid reimbursement ban primarily affects patients who go to Planned Parenthood for other services, like birth control, cervical cancer screening and treatment for sexually transmitted infections.
Some independent clinics offer non-abortion care, too, but many don’t accept Medicaid, clinic directors said at a Wednesday news briefing.
Amber Gavin is the vice president of advocacy of operations at A Woman’s Choice, an organization that has three clinics in North Carolina and one each in Florida and Virginia. She said staff members at the Charlotte location have seen an uptick in patients seeking STI testing and related services.
Karishma Oza, chief of staff at DuPont Clinic in Washington, D.C., also said providers there have seen an increase in patients who are uninsured or underinsured since the Medicaid ban, which mostly affects Planned Parenthood, took effect.
Phonekeo said the Wisconsin clinic hasn’t dealt with more demand for reproductive health care services beyond abortion. Still, Affiliated Medical Services offers birth control pills, IUDs, STI testing and treatment, miscarriage care and even follow-up care for medication abortion provided through online-only clinics such as Hey Jane.
While all three clinic leaders said they don’t accept Medicaid, they offer sliding-scale payments for people who cannot afford the full cost of care.
“We’re more than just abortion providers,” Phonekeo said.
This story was originally produced by News From The States, which is part of States Newsroom, a nonprofit news network which includes Wisconsin Examiner, and is supported by grants and a coalition of donors as a 501c(3) public charity.
Boxes of the diabetes drug Ozempic rest on a pharmacy counter in Los Angeles. Drugs like Ozempic have grown in popularity to treat obesity, prompting more than a dozen states to pay for them. But with major budget pressures, several state Medicaid agencies are either stopping coverage altogether or restricting who can get access to the therapy. (Photo illustration by Mario Tama/Getty Images)
Some states are rethinking their coverage of GLP-1 drugs for weight loss as budgets tighten and Medicaid programs brace for the cuts included in President Donald Trump’s broad tax and spending law.
As of Oct. 1, 16 state Medicaid programs covered GLP-1s for obesity treatment, up from 13 last year, according to a survey of Medicaid directors by KFF, a health policy research group. But some states have announced they will discontinue coverage or restrict who can qualify for it.
Many doctors and patient advocates say the drugs will save money in the long run by reducing obesity-related diseases such as heart disease and diabetes. Many states, however, have concluded they just can’t afford them.
North Carolina Medicaid ended coverage of GLP-1s for obesity last month, citing shortfalls in state funding. California, New Hampshire and South Carolina have said they will end coverage on Jan. 1. Starting next year, Michigan Medicaid will limit coverage to people who are “morbidly obese.” Pennsylvania, Rhode Island and Wisconsin also are considering new restrictions.
In last year’s KFF survey, about half the states said they were interested in covering GLP-1s for weight loss, according to Elizabeth Williams, a senior policy manager at KFF who focuses on Medicaid. This year, most states are moving in the opposite direction.
This likely reflects recent state budget challenges and the significant, significant costs associated with coverage.
– Elizabeth Williams, KFF senior policy manager
“This likely reflects recent state budget challenges and the significant, significant costs associated with coverage,” Williams said. “After a number of years of robust revenue growth right after the pandemic, states are starting to see slowing revenues, increasing spending demands and a lot of fiscal uncertainty due in part to recent federal actions.”
In April, the Trump administration scrapped a Biden-era proposal that would have required state Medicaid programs to pay for some GLP-1s for obesity treatment. Earlier this month, Trump announced that his administration had reached agreements with the manufacturers of Wegovy and Zepbound to reduce the prices of the drugs for Medicaid, Medicare and consumers buying the drugs directly, But it’s unclear whether the deals will reduce costs for states.
Health plans for state workers also are reassessing their coverage of the drugs for obesity. North Carolina, for example, ended GLP-1 obesity coverage for state workers last year, and West Virginia canceled a 1,000-person pilot program.
GLP-1 medications, which balance blood sugar levels, have long been prescribed to patients with Type 2 diabetes and cardiovascular conditions. All state Medicaid programs, which are funded jointly by the states and the federal government, cover GLP-1s for those uses.
But the drugs also curb hunger signals and can help people lose significant amounts of weight. Medications such as Ozempic, Wegovy and Zepbound have become wildly popular for that purpose.
Between 2019 and 2023, the number of outpatient Medicaid prescriptions for select GLP-1s to treat diabetes and obesity grew from 755,300 to 3.8 million, according to KFF. During the same period, Medicaid spending on those drugs increased from $597.3 million to $3.9 billion.
A study published last year in The BMJ, the journal of the British Medical Association, found that the number of patients without diabetes who started GLP-1 treatment in the United States increased from roughly 21,000 in 2019 to 174,000 in 2023, or more than 700%.
More than 2 in 5 U.S. adults have obesity, according to the federal Centers for Disease Control and Prevention. The CDC defines obesity as having a body mass index — a calculated measure of body weight relative to height — of 30 or higher. Obesity costs the U.S. health care system almost $173 billion per year, according to the agency.
Recently, the manufacturers of some GLP-1s have lowered their prices, selling them directly to consumers for $500 or less per month. But many patients cannot afford to pay that much out of pocket.
States in a tough financial position
In North Carolina, Dr. Jennifer McCauley, a weight management physician at UNC Health, said Medicaid coverage of GLP-1s was “incredibly helpful for our patients.”
“Now they’ve stopped coverage, so those people are now going back, regaining some of the weight, because they’re unable to obtain these medications, and also are suffering the health consequences of obesity,” McCauley told Stateline.
Some critics of expansive GLP-1 coverage say it isn’t cost effective, because many patients gain back the weight they lost when they stop treatment. But McCauley said the “downstream effects of obesity are even higher.”
“There are definitely vulnerable populations that probably would not be able to obtain weight loss without these medications.”
James Werner, a spokesperson at the North Carolina Department of Health and Human Services, blamed the coverage change on the state legislature’s failure to budget enough money for Medicaid.
In an email to Stateline, Werner said coverage of GLP1s for weight loss “would be reconsidered if Medicaid is fully funded.”
Some states are trying to maintain at least some coverage of the expensive drugs by tightening the eligibility requirements for a prescription, according to Colleen Becker, a project manager at the National Conference of State Legislatures, a policy research group.
“States are really looking at how to balance access and provide that access to patients, but they’re stewards of their budgets, and they need to be good stewards of it,” Becker said.
Michigan and Pennsylvania are among the states considering such options. Meanwhile, Connecticut has decided to maintain coverage of weight-loss drugs for state employees, but to require beneficiaries to try online weight-loss counseling before they can get a prescription.
Some future possibilities
One state, North Dakota, has taken a different approach to GLP-1 coverage after legislation that would have required the state’s Medicaid program to cover the drug failed. Instead, North Dakota this year became the first state to mandate that insurers on the state’s Affordable Care Act marketplace cover the drugs for weight loss.
North Dakota Deputy Insurance Commissioner John Arnold said the insurance department calculated that the mandate wouldn’t cause insurance premiums to rise significantly.
“It’s not that anybody can walk into the doctor’s office and say, ‘Hey, I want to have this covered,’” Arnold said. “It is really for those who have a medical need for the drugs, then it would be covered.”
The insurance department had to ask the legislature for permission to make the change, according to North Dakota Republican House Speaker Robin Weisz. He said insurance carriers were concerned that it was going to be “open season for everybody who could lose 20 or 30 pounds.”
He said it will take time to see whether the policy raises insurance premiums.
“If the carriers can come in a couple years and say, ‘Wow, here’s what we’ve spent on these … we’ll take a hard look at it,” Weisz said. “But, it’s way too early to tell at this point.”
Arnold says other states may have the flexibility to consider mandating ACA insurers to cover the drugs.
“Our biggest concern was reducing those comorbidities and the long-term impact that that has on the cost of insurance in general, because more comorbidities means more claims,” Arnold said, referring to diseases and conditions associated with obesity.
This story was originally produced by Stateline, which is part of States Newsroom, a nonprofit news network which includes Wisconsin Examiner, and is supported by grants and a coalition of donors as a 501c(3) public charity.
This story was originally published by ProPublica.
The most powerful Republican in Wisconsin stepped up to a lectern that was affixed with a sign reading, “Pro-Women Pro-Babies Pro-Life Rally.”
“One of the reasons that I ran for office was to protect the lives of unborn children,” Assembly Speaker Robin Vos told the cheering crowd gathered in the ornate rotunda of the state Capitol. They were there on a June day in 2019 to watch him sign four anti-abortion bills and to demand that the state’s Democratic governor sign them. (The governor did not.)
“Legislative Republicans are committed to protecting the preborn because we know life is the most basic human right,” Vos promised. “We will continue to do everything we can to protect the unborn, to protect innocent lives.”
Now, however, Vos has parted with some in the national anti-abortion movement in its push for a particular measure to protect life: the life of new mothers.
Many anti-abortion Republicans have supported new state laws and policies to extend Medicaid coverage to women for a year after giving birth, up from 60 days. The promise of free health care for a longer span can help convince women in financial crises to proceed with their pregnancies, rather than choose abortion, proponents say. And many health experts have identified the year after childbirth as a precarious time for mothers who can suffer from a host of complications, both physical and mental.
Legislation to extend government-provided health care coverage for up to one year for low-income new moms has been passed in 48 other states — red, blue and purple. Not in Arkansas, where enough officials have balked. And not in Wisconsin, where the limit remains two months. And that’s only because of Vos.
The Wisconsin Senate passed legislation earlier this year that would increase Medicaid postpartum coverage to 12 months. In the state Assembly, 30 Republicans have co-sponsored the legislation, and there is more than enough bipartisan support to pass the bill in that chamber.
But Vos, who has been speaker for nearly 13 years and whose campaign funding decisions are considered key to victory in elections, controls the Assembly. And, according to insiders at the state Capitol, he hasn’t allowed a vote on the Senate bill or the Assembly version, burying it deep in a committee that barely meets: Regulatory Licensing Reform.
Vos’ resistance has put him and some of his anti-abortion colleagues in the odd position of having to reconcile their support for growing families with the failure of the Assembly to pass a bill aimed at helping new moms stay healthy.
“If we can’t get something like this done, then I don’t know what I’m doing in the Legislature,” Republican Rep. Patrick Snyder, the bill’s author and an ardent abortion foe, said in February in a Senate hearing.
Reached by phone, Vos declined to discuss the issue with ProPublica and referred questions to his spokesperson, who then did not respond to calls or emails. Explaining his opposition, Vos once said, “We already have enough welfare in Wisconsin.” And in vowing to never expand Medicaid, he has said the state should reserve the program only for “those who truly need it.”
His stance on extending benefits for new mothers has troubled health care professionals, social workers and some of his constituents. They have argued and pleaded with him and, in some cases, cast doubt on his principles. ProPublica requested public comments to his office from January 2024 to June 2025 and found that the overwhelming majority of the roughly 200 messages objected to his stance.
“I know this is supported by many of your Republican colleagues. As the ‘party of the family’ your opposition is abhorrent. Get with it,” one Wisconsin resident told the speaker via a contact form on Vos’ website.
Another person who reached out to Vos chastised him for providing “lame excuses,” writing: “The women of Wisconsin deserve better from a party that CLAIMS to be ‘pro-life’ but in practice, could care less about women and children. We deserve better than you.”
‘A commonsense bill’
Donna Rozar is among the Wisconsin Republicans who staunchly oppose abortion but also support Medicaid for new mothers.
While serving as a state representative in 2023, she sponsored legislation to extend the coverage up to one year. Her effort mirrored what was happening in other states following the end of Roe v. Wade and the constitutional right to an abortion. Activists on both sides of the abortion issue recognized that there could be a rise in high-risk births and sought to protect mothers.
“I saw this as a pro-life bill to help mothers have coverage for up to a year, in order to let them know that they would have the help they needed if there were any postpartum complications with their pregnancy,” said Rozar, a retired registered nurse. “I thought it was a commonsense bill.”
Vos, she said, would not allow the bill to proceed to a vote even though it had 66 co-sponsors in the 99-person chamber. “The speaker of the state Assembly in Wisconsin is a very powerful individual and sets the agenda,” she said.
Rozar recalled having numerous “frustrating” conversations with Vos as she tried to persuade him to advance the legislation. “He was just so opposed to entitlement programs and any additional expenditures of Medicaid dollars that he just stuck to that principle. Vehemently.”
Donna Rozar, a Republican former state representative from Marshfield, sponsored legislation in 2023 to extend Medicaid coverage for mothers but said Assembly Speaker Robin Vos wouldn’t even allow a vote on the bill. She is seen at Gov. Tony Evers’ State of the State address on Jan. 24, 2023, in Madison, Wis. (Drake White-Bergey / Wisconsin Watch)
Vos has argued as well that through other options, including the Affordable Care Act, Wisconsinites have been able to find coverage. While some new mothers qualify for no-cost premiums under certain ACA plans, not all do. Even with no-cost premiums, ACA plans typically require a deductible or co-payments. And next year, when enhanced premium tax credits are due to expire, few people will be eligible for $0 net premiums unless Congress acts to change that.
Rozar lost her race for reelection in August 2024 after redistricting but returned to the state Capitol in February for a Senate hearing to continue advocating for the extension. She was joined by a variety of medical experts who explained the extreme and life-threatening risks women can face in the first year after giving birth.
They warned that without extended Medicaid coverage, women who need treatment and medication for postpartum depression, drug addiction, hypertension, diabetes, blood clots, heart conditions or other ailments may be unable to get them.
One legislative analysis found that on average each month, 700 women fell off the Medicaid rolls in Wisconsin two months after giving birth or experiencing a miscarriage because they no longer met the income eligibility rules.
Justine Brown-Schabel, a community health worker in Dane County, told senators of a new mother diagnosed with gestational diabetes who lost Medicaid coverage.
“She was no longer able to afford her diabetes medication,’’ Brown-Schabel said. “Not only did this affect her health but the health of her infant, as she was unable to properly feed her child due to a diminishing milk supply.”
She described another new mother, one who had severe postpartum depression, poor appetite, significant weight loss, insomnia and mental exhaustion. Sixty days of Medicaid coverage, Brown-Schabel said, “are simply not enough” in a situation like that.
Currently, new moms with household incomes up to 306% of the poverty line (or $64,719 a year for a single mom and baby) can stay on Medicaid for 60 days after birth. But the mother must be below the poverty line ($21,150 for that mom and baby) to continue with coverage beyond that. The new legislation would extend the current protections to a year.
Bipartisan unity on the legislation is so great that Pro-Life Wisconsin and the lobbying arm of the abortion provider Planned Parenthood, which offers some postpartum services, both registered in support of it before the Senate.
“It’s something that we can do and something that’s achievable given the bipartisan support for it,” Matt Sande, a lobbyist for Pro-Life Wisconsin, said in an interview. “It’s not going to break the bank.”
Once fully implemented, the extended coverage would cost the state $9.4 million a year, according to the state Legislative Fiscal Bureau. The state ended fiscal year 2025 with a budget surplus of $4.6 billion.
With the Assembly bill buried by Vos, Democratic Rep. Robyn Vining tried in July to force the issue with a bit of a legislative end run. She rose during floor debate on the state budget and proposed adding the Medicaid extension to the mammoth spending bill.
All of the Republicans who had signed on to the Medicaid bill, except one absent member, voted to table the proposal, sinking the amendment. They included Snyder, the bill’s sponsor, who in an email to ProPublica labeled the Democrats’ move to raise the issue during floor debate “a stunt.”
“Democrats were simply more concerned with playing political games to garner talking points of who voted against what, than they were in supporting the budget negotiated by their Governor,” he said.
Said Vining of the Republicans who tabled the amendment: “They’re taking marching orders from the speaker instead of representing their constituents.”
Well-funded opposition
Vos’ opposition echoes that of influential conservative groups, including the Foundation for Government Accountability, a Florida think tank that promotes “work over welfare.” Its affiliated lobbying arm openly opposed the Medicaid extension for new moms when it first surfaced in Wisconsin in 2021, though it has not registered opposition since then. Reached recently, a spokesperson for the foundation declined to comment.
Over the past decade, the foundation has received more than $11 million from a charitable fund run by billionaire Richard Uihlein, founder of the Wisconsin-based shipping supplies company Uline. In recent years, Uihlein and his wife, Liz, also have been prolific political donors nationally and in the Midwest, with Vos among the beneficiaries.
Since 2020, Liz Uihlein has given over $6 million to Wisconsin’s Republican Assembly Campaign Committee, which is considered a key instrument of Vos’ power. And in February 2024, she donated $500,000 to Vos’ personal political campaign at a time when he was immersed in a tough intraparty skirmish.
One concern cited by extension opponents such as the Foundation for Government Accountability is that Medicaid coverage for new moms could be used for health issues not directly related to giving birth. Questions over how expansive the coverage would be spilled into debate in Arkansas in a Senate committee in April of this year.
“Can you explain what that coverage is? Is it just like full Medicaid for any problem that they have, or is it somehow specific to the pregnancy and complications?” asked GOP Sen. John Payton.
A state health official told him new mothers could receive a full range of benefits.
“Like, if they needed a knee replacement, I mean, it’d cover it?” Payton said.
“Yes,” came the reply.
The bill failed in a voice vote.
In Wisconsin, no lawmaker voiced any such concern during the February Senate hearing, which was marked by only positive feedback. In fact, one lawmaker and some medical experts in attendance openly snickered at the thought that Arkansas — a state that ranks low in public health measurements — might pass legislation before Wisconsin, leaving it the lone holdout.
Ultimately, the Wisconsin Senate approved the legislation 32-1 in April, sending it along to the Assembly to languish and leaving Wisconsin still in the company of Arkansas on the issue.
Despite the setbacks and Vos’ firm opposition, Sande of Pro-Life Wisconsin and other anti-abortion activists are not giving up. He thinks Vos can be persuaded and the bill could move out of its purgatory this winter.
“I’m telling you that we’re hopeful,” Sande said.
Rozar is, too, even though she is well aware of Vos’ unwavering stance. “He might have egg on his face if he let it go,” she said.
ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.
Planned Parenthood of Wisconsin resumed scheduling abortions on Monday after a nearly monthlong pause due to federal Medicaid funding cuts in President Donald Trump’s tax and spending bill that took effect at the beginning of October.
Planned Parenthood of Wisconsin said it was able to resume scheduling abortions as of noon on Monday because it no longer fits the definition of a “prohibited entity” under the new federal law that took effect this month and can receive Medicaid funds.
The organization said it dropped its designation as an “essential community provider” as defined under the Affordable Care Act. Dropping the designation will not result in changes to the cost for abortions or other services or affect the organization’s funding, Planned Parenthood of Wisconsin President and CEO Tanya Atkinson said.
“At this point, in all of our research and analysis, we really shouldn’t see much of an impact on patient access,” she said. “If relinquishing this does ultimately impact our bottom line, then we will have to understand what that path forward is.”
A national fight over abortion funding
Abortion funding has been under attack across the U.S., particularly for affiliates of Planned Parenthood, the biggest provider. The abortion landscape has shifted frequently since the U.S. Supreme Court ruling in 2022 that allowed states to ban abortion. Currently, 12 states do not allow it at any stage of pregnancy, with limited exceptions, and four more ban it after about six weeks’ gestation.
Planned Parenthood has warned that about half its clinics that provide abortion could be closed nationwide due to the ban in the new federal law on Medicaid funding for Planned Parenthood for services other than abortion.
Wisconsin, where abortion is legal but the Republican-controlled Legislature has passed numerous laws limiting access, was the only state where Planned Parenthood paused all abortions because of the new federal law, Atkinson said.
Because of the complexities and varieties of state abortion laws, Planned Parenthood affiliates are responding to the new federal law in a variety of ways, Atkinson said. In Arizona, for example, Planned Parenthood stopped accepting Medicaid but continued to provide abortions.
The move in Wisconsin is “clearly aimed at sidestepping” the federal law, Wisconsin Right to Life said.
“Planned Parenthood’s abortion-first business model underscores why taxpayer funding should never support organizations that make abortion a priority,” said Heather Weininger, executive director of Wisconsin Right to Life. “Women in difficult circumstances deserve compassionate, life-affirming care — the kind of support the pro-life movement is committed to offering.”
Impact on Wisconsin abortion clinics
In Wisconsin, pausing abortions for the past 26 days meant that women who would normally go to clinics in the southeastern corner of the state instead had to look for other options, including traveling to Chicago, which is within a three-hour drive of the Planned Parenthood facilities.
Affiliated Medical Services and Care for All also provide abortions at clinics in Milwaukee.
Atkinson said it was “really, really difficult to say” how many women were affected by the pause in services. She did not have numbers on how many women who wanted to have an abortion since the pause went into effect had to seek services elsewhere.
Planned Parenthood of Wisconsin serves about 50,000 people, and about 60% of them are covered by Medicaid, the organization said.
Given those numbers, the priority was on finding a way to continue receiving Medicaid funding and dropping the “essential community provider” status, Atkinson said.
Wisconsin is part of a multistate federal lawsuit challenging the provision in the law. A federal appeals court in September said the government could halt the payments while a court challenge to the provision moves ahead.
Ramifications for Medicaid
Planned Parenthood of Wisconsin cited a Sept. 29 court filing on behalf of U.S. Health and Human Services that said family planning organizations could continue billing Medicaid if they gave up either their tax-exempt status or the “essential community provider” designation.
By giving up that designation, it no longer fits the definition of “prohibited entity” under the federal law and can continue to receive federal Medicaid funds, the organization said. Planned Parenthood of Wisconsin is not giving up its tax-exempt status.
The “essential community provider” designation was originally given to organizations to help make it easier for them to be considered in-network for billing with private health insurers, Planned Parenthood said.
Atkinson called it a “nuanced provision” of the law and she does not anticipate that giving it up will affect Planned Parenthood’s ability to continue providing abortions and other services.
Planned Parenthood provides a wide range of services including cancer screenings and sexually transmitted infection testing and treatment. Federal Medicaid money was already not paying for abortion, but affiliates relied on Medicaid to stay afloat. Services other than abortion are expected to expand in light of the new law.
Planned Parenthood performed 3,727 abortions in Wisconsin between Oct. 1, 2023, and Sept. 30, 2024, the group said.
Wisconsin Watch is a nonprofit and nonpartisan newsroom. Subscribe to our newsletters to get our investigative stories and Friday news roundup.This story is published in partnership with The Associated Press.
Although President Donald Trump’s “One Big Beautiful Bill Act” offers new tax deductions and credits across different income levels, low-income households – the bottom 20% of income earners – are largely excluded from any significant tax benefits.
“It’s particularly shocking because the law is so big,” said Elaine Maag, a senior fellow at The Urban-Brookings Tax Policy Center. “Typically, when trillions of dollars are spent, you see it really spread across the income distribution.”
The bill was signed into law over the summer.
Benefits that people with low incomes do receive may be outweighed when considered alongside other provisions in the bill, said Andrew Reschovsky, professor emeritus of public affairs and applied economics at the University of Wisconsin-Madison.
“This is the dilemma – if you count those things in with the tax side, the net will be that a lot of people are going to be worse off.”
Credits and deductions
A credit is an amount subtracted directly from the tax you owe while a deduction reduces the amount of income that can be taxed. Both can help keep more money in taxpayers’ pockets.
The bill establishes new credits and deductions.
The bill increases the:
Child Tax Credit from $2,000 per qualifying child to $2,200.
Child and Dependent Care Credit, which allows taxpayers to subtract certain costs associated with caring for children under 13 or dependents incapable of self-care.
The bill introduces new deductions for:
Workers in jobs where tips are common, allowing them to deduct up to $25,000 of tip income.
Individuals who work overtime, allowing them to deduct up to $12,500 of overtime pay.
People 65 and older, allowing them to deduct $6,000.
Limitations
These changes may appear to help people who are financially struggling. But the bill affects federal taxes, so its new deductions and credits apply only to income taxable by the federal government.
People with low income generally owe little or no federal income tax.
Older low-income adults, for example, often rely primarily or entirely on Social Security benefits and are generally not subject to federal taxes. This means that a new $6,000 deduction would not benefit them, Rechovsky said.
Rechovsky noted other reasons the new deductions are misleading or extremely narrow.
“Yes, you’re a waiter and you benefit from not paying taxes on your tips,” he said. “But take someone in the same income range who works as a home health care worker – they don’t benefit at all.”
Reschovsky also questions how those with low incomes would benefit from reducing the amount owed on overtime pay.
“One of the reasons some people are low-income is that they’re lucky to get a 40-hour workweek,” he said.
The same limitation applies to the new credits.
An analysis by Maag estimates that in 2025 about 17 million children under 17 – or one in four – will receive less than the full value of the Child Tax Credit because their parents earn too little.
The bill also changes which families qualify based on citizenship status.
The Child Tax Credit will be limited to children who are U.S. citizens and have at least one parent with a valid Social Security number.
About 2 million U.S. citizen children will lose their Child Tax Credit because of this new requirement, Maag wrote, citing an analysis from the Joint Committee on Taxation.
Safety nets
One benefit to people with low incomes from the bill is that it makes permanent many provisions from the 2017 Tax Cuts and Jobs Act, including lower income tax rates and larger standard deductions.
“It’s true across the board that if taxes go down, your income after taxes goes up,” Reschovsky said.
But for those with low incomes, the increase is minimal and will likely be outweighed by changes to Medicaid, premium subsidies provided by the Affordable Care Act and changes to SNAP.
“It’s just that classic view … that, ‘Well, these people are just sucking on the teat of the federal government, so we’re going to just make it as hard as possible for them to do that, because they’re just freeloaders,’” said Anthony Myers, program director of the Riverworks Financial Clinic.
Where to get help
For people with incomes under $67,000, free tax assistance is available through programs such as the IRS’ Volunteer Income Tax Assistance, or VITA.
Planned Parenthood of Wisconsin will stop scheduling patients for abortions starting next week as it works to find a way to provide the service in the face of Medicaid funding cuts in President Donald Trump’s tax and spending bill, the nonprofit said Thursday.
Abortion funding across the U.S. has been under siege, particularly Planned Parenthood affiliates, which are the biggest provider. Wisconsin appears to be the first state where Planned Parenthood is pausing abortions because of the new law.
The organization warned earlier this year that about half its clinics that provide abortion could be closed as a result of a ban on Medicaid funding for Planned Parenthood for services other than abortion.
The measure was part of the tax and spending law President Donald Trump signed in July. Initially, a judge said reimbursements must continue, but a federal appeals court this month said the government could halt the payments while a court challenge to the provision moves ahead.
Planned Parenthood services include cancer screenings and sexually transmitted infection testing and treatment. Federal Medicaid money was already not paying for abortion, but affiliates relied on Medicaid to stay afloat.
The remaining Planned Parenthood clinics in Louisiana – where abortion is banned – are scheduled to shut down at the end of this month.
Planned Parenthood of Wisconsin said in a statement that it is trying to see as many patients as possible between now and Tuesday. The federal law takes effect Wednesday. It is not scheduling patients beyond that date, and the organization believes the move will allow it to continue seeing other Medicaid patients. The organization said it was working with providers across the state to make sure patients are referred quickly and receive timely care.
It is also considering taking legal action, the group said.
“Planned Parenthood of Wisconsin will continue to provide the full spectrum of reproductive health care, including abortion, as soon and as we are able to,” Planned Parenthood of Wisconsin President and CEO Tanya Atkinson said in the statement. “In the meantime, we are pursuing every available option through the courts, through operations, and civic engagement.”
The abortion landscape has been shifting frequently since the U.S. Supreme Court ruling in 2022 that allowed states to ban abortion. Currently, 12 states do not allow it at any stage of pregnancy, with limited exceptions, and four more ban it after about six weeks’ gestation.
The bans have resulted in more women traveling for abortion and an increased reliance on abortion pills. Prescribers in states where they’re allowed have been shipping the pills to places where abortion is banned, a practice that is facing some legal challenges and is expected to attract more.
The Wisconsin Supreme Court in July struck down the state’s 1849 near-total ban on abortion, saying it was superseded by newer state laws regulating the procedure. The same day it ruled in that case, the court dismissed a lawsuit filed by Planned Parenthood of Wisconsin asking it to find the law unconstitutional.
Wisconsin’s abortion ban was in effect until 1973, when the U.S. Supreme Court’s landmark Roe v. Wade decision legalizing abortion nationwide nullified it. Legislators never officially repealed it, however, and conservatives argued that the U.S. Supreme Court’s ruling that overturned Roe reactivated it.
Planned Parenthood of Wisconsin stopped providing abortions after that ruling for 15 months before resuming them as the lawsuit over the state law played out. It has been providing abortions at three clinics in Wisconsin for the past two years.
Planned Parenthood of Wisconsin serves about 50,000 people across the state. About 60% of them are covered by Medicaid, the organization said.
The federal Hyde Amendment already restricts government funding for most abortions, and less than 5% of the services Planned Parenthood provides are abortions, according to the organization’s 2023 annual report.
Planned Parenthood provides a wide range of services besides abortion. Its most recent annual report shows that contraceptive services and testing and treatment for sexually transmitted infections make up the vast majority of its medical care. It performs more cancer screening and prevention procedures than abortions, according to the report.
Mulvihill reported from Cherry Hill, New Jersey. Associated Press reporter Christine Fernando in Chicago contributed.
Wisconsin Watch is a nonprofit and nonpartisan newsroom. Subscribe to our newsletters to get our investigative stories and Friday news roundup.This story is published in partnership with The Associated Press.
Americans who earn less than $18,000 are estimated to see a slight federal tax cut under President Donald Trump’s big bill, but the net effect of the bill is likely to lead to a loss in household resources.
The average federal tax change from current levels for the bottom 20% of American earners is a reduction of $150 by 2026 and a reduction of $160 by 2030, according to estimates from the nonpartisan Tax Policy Center. In contrast, the average income earner will receive a $2,860 cut while the top 1% of earners will see a $75,410 cut on average.
Lower income earners already pay little in taxes. Reductions in Medicaid and SNAP benefits are likely to affect lower income earners disproportionately, resulting in a projected net decline of 2.9% in their household resources.
This fact brief is responsive to conversations such as this one.
Providing the best care for the students, empowering the transportation staff, and building an operational culture of communication and clear policies will be discussed by industry veterans, transportation consultants, and school district and bus company staff members.
In the driver training category, session topics include how to model behavior interventions in transportation settings, training for empathy of children’s needs, providing training for the service of medically fragile riders, and other proactive training educational discussions.
For upholding legal requirements and federal standards, speakers will plan to address topics such as impact of the updated National School Bus Specifications and Procedures on operations, alternative transportation, Medicaid reimbursement funding, and developing policies for proper and safe usage of student restraint and seclusion practices.
To address collaborating with contractors or other resources to aid student transportation, examples of topics include how to avoid one-size-fits-all solutions, how to create successful partnerships between school districts and contractors, and the OT/PT Transporter Forum on multidisciplinary policy development.
In addition to the hands-on training classes that cover wheelchair securement, school bus evacuations and use of child safety restraint systems on school buses, instructors from the Texas School for the Deaf will provide training for student transporters on using American Sign Language to communicate.
For a full list of 2025 TSD conference topics, visit tsdconference.com.
Save $100 on regular conference registration with Early Bird registration by Oct. 3. The TSD Conference will be held November 6-11 in Frisco, Texas at the Embassy Suites Dallas-Frisco Hotel and Convention Center. Find more information on daily agenda, unique experiences, hotel and registration at tsdconference.com
For over a decade, Wisconsin has heard the same message from Republicans regarding full Medicaid expansion: Accepting 90% federal reimbursement to cover more low-income people will only set Wisconsin up for failure if the federal government abandons its part of the deal.
At first glance, President Donald Trump’s recently signed big bill appears to validate that argument. The 40 states that have fully expanded are now expected to lose billions of dollars in federal aid while getting tagged with additional administrative costs to create work requirements and eligibility assessments required in the bill.
But it turns out Wisconsin is still going to be subject to the new federal mandates without the higher federal reimbursement rate that expansion states will continue to receive. In other words, at a time when the Republican-controlled federal government is supposedly pulling out the rug from expansion states, Wisconsin is still left holding the bag.
A look back
Back in 2014, then-Gov. Scott Walker and Wisconsin Republicans made the controversial decision not to accept full Medicaid expansion.
At the time, Walker explained his goal “is to get more people out into the workplace, more people covered when it comes to health care and fewer people dependent on the government, not because we’ve kicked them out, but we’ve empowered them to take control of their own destiny.”
But he also argued that the federal government would eventually pull back on its commitment to fund Medicaid at 90%.
“That commitment is not going to be there and taxpayers all across America will be on the hook,” Walker said. “They are not going to be on the hook in Wisconsin.”
At the time, Wisconsin was one of 25 states not accepting expansion. Now, the state is one of the 10 remaining holdouts, with most of the others in the deep red South. Even reliably red states, like Arkansas and Louisiana, have accepted full expansion.
Instead of accepting full expansion, Wisconsin chose to cover individuals through BadgerCare, the state’s Medicaid-supported health insurance program for low-income residents set up by former Gov. Tommy Thompson, a Republican.
Walker and Republicans lowered Medicaid coverage to 100% of the federal poverty line from the previous 200% and eliminated the waiting list for childless adults. Those above the poverty line without employer-sponsored insurance could purchase it through the Affordable Care Act marketplace using federal subsidies, according to the Wisconsin Policy Forum.
But Wisconsin taxpayers are paying more to cover individuals below the poverty line: 39.3% of costs rather than 10% under full Medicaid expansion. In 2023, Medicaid accounted for 15.7% of state taxpayer spending, according to the policy forum.
Under its approach, Wisconsin doesn’t have an eligibility gap like some states, something Republicans highlight as a reason the state doesn’t need to expand.
But that has come with a loss of federal funds. Over the past decade, Wisconsin’s Department of Health Services estimates, the state has spent about $2.6 billion more to cover the costs of a partial expansion compared with the projected cost under a federal expansion.
Under an expansion, more individuals would be able to access Medicaid. But the Wisconsin Policy Forum found it would have a somewhat modest impact on coverage levels — the percentage change in Medicaid enrollees would be 7.2%, compared with nearly 30% or more in other non-expansion states.
Work requirements still in effect under Trump bill
With the recent federal bill, Walker and other Republicans still argue Wisconsin was right not to accept federal expansion. The state is going to experience the impacts to a lesser extent than fully expanded states.
But because Wisconsin receives federal waivers for its Medicaid program, the state is still subject to some provisions under the new law, including the work requirements, eligibility determinations and provider taxes.
Under the new work requirements, individuals covered by Medicaid are required to prove they are working 80 hours per month — parents with dependent children or people who are medically frail are exempted.
As a result, some 230,000 Wisconsin residents could lose coverage while the state incurs administrative costs to account for the new requirements, according to an estimate from U.S. Senate Democrats based on data from the Congressional Budget Office.
The work requirements don’t stop at individuals covered by Medicaid alone; it also extends to coverage through marketplace subsidies, affecting over 200,000 Wisconsin residents.
Work requirements used to be required for Wisconsin residents to access coverage through federal waivers, but in 2021 then-President Joe Biden removed the work requirement.
The labor force participation rate has dipped from about 68% in 2017 to a little over 65% as of May 2025 but has remained higher than the national average, which is about 62%. Some reports suggest that decline is due to the aging workforce in the state.
Work requirements have also been found to increase the uninsured rate.
The Wisconsin Policy Forum reports that one of the main reasons work requirements may lead to higher uninsured rates is that they are confusing and time-consuming. Some people may choose to get rid of coverage altogether to avoid unnecessary paperwork.
What could happen with the federal bill?
The Kaiser Family Foundation also found that implementing work requirements will be costly for states, costing anywhere from $10 million to over $270 million, depending on the size of the state. DHS estimates the state will pay $6 million annually to implement work requirements, while receiving a lower federal match rate than fully expanded states to reimburse for administrative costs.
With a lower federal match rate, Wisconsin has increased Medicaid funding through hospital taxes, which the new state budget just increased from 1.8% to the federal maximum of 6% for the 2025-27 biennium budget.
Republican lawmakers in the state were quick to approve the hospital tax increase, despite their previous opposition to Medicaid expansion as a means for drawing down additional federal funding. If they hadn’t, the state’s 1.8% tax would have been frozen under Trump’s big bill. The increase will raise some $1 billion more annually in federal matching funds that the state can use to pay hospitals for care they provide Medicaid patients.
States that expanded will not lose the 90% federal match rate, but those like Wisconsin that didn’t will now miss out on an additional incentive to expand created during the Biden administration.
The incentive would have raised the federal match rate to 95% for two years, but was eliminated by Trump’s big bill. Instead Wisconsin will remain at about 60% reimbursement, while still facing the same bureaucratic requirements as expansion states.
Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.
Wisconsin will receive an estimated $1 billion more annually in federal funds for Medicaid because the state budget includes a change that pre-empts a provision in President Donald Trump’s big bill.
Trump’s bill would have prevented Wisconsin from raising its hospital tax.
But days before Trump signed it, the Republican-led Legislature and Democratic Gov. Tony Evers approved a 2025-27 state budget that raises Wisconsin’s hospital tax from 1.8% to 6%.
The increase will raise some $1 billion more annually in federal matching funds that the state can use to pay hospitals for care they provide Medicaid patients.
Wisconsin’s largest Medicaid program is BadgerCare Plus, which provides health insurance to about 1 million low-income people age 64 and under.
Republican U.S. Rep. Derrick Van Orden, who represents western Wisconsin, claimed that Trump’s bill “secured” the $1 billion.
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