The Relentless School Nurse: The “Big Beautiful Bill is Actually a “Big Brutal Betrayal”

Like many school nurses, I have witnessed firsthand the consequences when policy decisions overlook the children and families who depend on our nation’s safety net. The passage of the so-called “Big Beautiful Bill” is being hailed by its supporters as a victory for American families, but beneath the celebratory rhetoric lies a harsh truth: this legislation is a brutal betrayal, especially of our most vulnerable. The passage of H.R. 1 on the eve of the 4th of July adds to the cruelty. 

This bill is not a lifeline—it is a brutal betrayal.

Medicaid Cuts: Turning Our Backs on Vulnerable Children

Despite assurances from its backers, independent analyses show the bill will lead to deep federal cuts to Medicaid—up to $800 billion over the next decade. Medicaid and CHIP together insure nearly half of all children in the U.S., including those with disabilities and those living in rural communities. The bill’s new work requirements and bureaucratic hurdles will make it harder for millions of families to maintain coverage. The Congressional Budget Office and child health advocates warn that as many as one in five children could lose their Medicaid coverage, forcing states to choose between cutting services or raising taxes. For children who need insulin, speech therapy, or access to a school nurse, this is not just a policy change—it is a life-altering loss.

Feeding Tax Breaks, Not Hungry Children

The bill tightens eligibility for food assistance programs like SNAP, imposing new work requirements and administrative red tape. This means that millions of children will lose access to the food they need, both at home and at school—since SNAP enrollment often determines eligibility for free school meals. The CBO estimates the poorest households will lose about $1,600 a year in resources, while the wealthiest will see gains of $12,000. We know what hunger does: it stunts learning, fuels anxiety, and makes children sick. Passing legislation that knowingly increases child hunger is a national disgrace.

Tax Credits That Leave Millions Behind

While the bill raises the child tax credit for some, it locks out millions of the lowest-income children by adding new barriers and requirements. Families with the least—especially those with immigrant parents—will be excluded from benefits that could have helped lift them out of poverty. At the same time, wealthier families will find it easier to claim the full credit, widening the gap between those who have and those who have not.

Stripping Schools of Essential Services

With Medicaid funding slashed schools will lose critical resources for health staff, counselors, and services for students with disabilities. Under-resourced districts will be hit hardest, leaving more children without the support they need to learn and thrive. When school nurses, counselors, and aides are cut, children’s health and educational outcomes suffer.

“Savings” Accounts for Some, Sacrifice for Others

The bill’s new “Trump Accounts” are touted as a way to help families save for their children’s future. In reality, these accounts benefit those who already have extra money to save, leaving low-income families behind. For many, these accounts are empty promises.

Who Wins, and Who Pays the Price?

This is not just a policy debate. This is about children. This is about who we choose to protect—and who we leave behind. The “Big Brutal Betrayal Bill” may be beautiful for some, but for the children who rely on Medicaid, for the families struggling to put food on the table, and for the students who count on their school nurse, it is a calculated and cruel step backward.

This bill reflects a dangerous truth: in the pursuit of tax breaks, our nation’s leaders have decided that some children matter less.

School nurses will see the faces behind these policy decisions. The child whose asthma is unmanaged because their coverage was cut. The student too hungry to focus on learning. Families making impossible choices between food or healthcare, housing or self-deportation. We are on the frontlines, left with even fewer options to offer help to our families.