Medicaid is the fourth largest federal funding source for K-12 schools, supporting over $7.5 billion of school-based health services every year. If Congress cuts Medicaid, states -- and school districts -- will receive less funding. This will force states and local communities to increase taxes and reduce or eliminate various programs and services, including non-Medicaid services. Given that a strong school Medicaid program relies on a strong federal Medicaid program, Healthy Schools Campaign and its partners asked school district leaders, including superintendents, school business officials and other school health and administrative staff, to assess how reductions in federal financing would affect school health services, student resources and district funding. A total of 1,440 responses were collected from all 50 states and the District of Columbia. 90% of respondents anticipate that Medicaid cuts would lead to reductions across their district's budget, outside of school health services. [This project was created with the partnership of the National Alliance for Medicaid in Education.]