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A school district's budget has to cover a lot before the first student walks through the door. Teachers and support staff need to be hired, buses need fuel, and buildings need heat. When those costs rise, school boards have to make difficult choices about how to meet students' needs with the dollars available.
Health care can be one of the biggest variables in that equation. Districts need to provide dependable coverage for their employees, but an unexpected increase in costs can upend months of careful planning and leave less money available for classrooms.
For a school board, those increases carry consequences well beyond a line in the budget. They can determine whether a district fills an open position, replaces aging equipment, or puts off a building repair for another year. Having served on the Board of Education and Wellsville City Council, I believe lawmakers need to consider those local consequences when evaluating federal health care policy.
As cost pressures creep up across the board, we can't afford loopholes at the federal level to push up school districts' health care costs.
Unfortunately, that is exactly the concern with a federal law called the No Surprises Act, passed several years ago to fight surprise medical bills. While the law has reduced out-of-pocket costs for patients and taken them out of the middle of billing disputes, its arbitration mechanism, known as Independent Dispute Resolution or IDR, has produced payouts far above typical in-network rates.
A recent analysis demonstrates how the costs have piled up. Median prevailing provider awards for emergency department services reached 315 percent of the in-network benchmark in 2025, while other specialties shot up even higher. Radiology awards reached 468 percent of the benchmark, while neurological care reached 2,450 percent. Providers prevailed in approximately 85 percent of disputes that year.
Underneath the complex terminology and statistics are real concerns for school budgets in Ohio. For districts that self-fund their health plans, higher claim payments can directly increase the cost of providing employee coverage. Other districts can feel rising health care costs through higher insurance premiums. The researchers estimated that costs attributable to the IDR process reached $16.6 billion in 2025, more than three times the cost in 2024. Those expenses add pressure on employers and employees already facing higher health care prices.
For school districts that need to balance their budgets, these costs can't be ignored. In some communities, the school district is one of the largest employers. Cost pressures that limit wage increases and push up employee health care contributions affect educators, support staff, and the local economy.
This is unfolding at a time when Ohio school districts are managing competing demands for staffing, transportation, building maintenance, and classroom resources. Rising energy costs and the price of everyday supplies make those decisions even harder. Many of these factors are outside of school board members' control, so when federal policy adds avoidable costs, it's critical that legislators take action to make the needed fix and chip away at runaway health care expenses.
Congress should pursue legislation to tackle this issue and put Ohio's school districts, businesses, and families on sturdier financial footing. Logical reforms to bring awards more in line with credible in-network benchmarks, while accounting for the circumstances of the care provided, are a good place to start. Lawmakers should preserve the protections that keep patients out of billing disputes while addressing the incentives driving excessive costs.
School districts have to account for every dollar they spend. Reforming this system should be a priority for Congress so more of those dollars can support the employees and classrooms our students depend on.
John Morrow
Liverpool Township