By Jackie Fortiér and Arthur Allen, KFF Health News

In the dim basement of a Salt Lake City pharmacy, hundreds of amber-colored plastic pill bottles sit stacked in rows, one man’s defensive wall in a tariff war.

Independent pharmacist Benjamin Jolley and his colleagues worry that the tariffs, aimed at bringing drug production to the United States, could instead drive companies out of business while raising prices and creating more of the drug shortages that have plagued American patients for several years.

Jolley bought six months’ worth of the most expensive large bottles, hoping to shield his business from the 10% across-the-board tariffs on imported goods that President Donald Trump announced April 2. Now with threats of additional tariffs targeting pharmaceuticals, Jolley worries that costs will soar for the medications that will fill those bottles.

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In principle, Jolley said, using tariffs to push manufacturing from China and India to the U.S. makes sense. In the event of war, China could quickly stop all exports to the United States.

“I understand the rationale for tariffs. I’m not sure that we’re gonna do it the right way,” Jolley said. “And I am definitely sure that it’s going to raise the price that I pay my suppliers.”

Squeezed by insurers and middlemen, independent pharmacists such as Jolley find themselves on the front lines of a tariff storm. Nearly everyone down the line — drugmakers, pharmacies, wholesalers, and middlemen — opposes most tariffs.

Slashing drug imports could trigger widespread shortages, experts said, because of America’s dependence on Chinese- and Indian-made chemical ingredients, which form the critical building blocks of many medicines. Industry officials caution that steep tariffs on raw materials and finished pharmaceuticals could make drugs more expensive.

“Big ships don’t change course overnight,” said Robin Feldman, a UC Law San Francisco professor who writes about prescription drug issues. “Even if companies pledge to bring manufacturing home, it will take time to get them up and running. The key will be to avoid damage to industry and pain to consumers in the process.”

Trump on April 8 said he would soon announce “a major tariff on pharmaceuticals,” which have been largely tariff-free in the U.S. for 30 years.

“When they hear that, they will leave China,” he said. The U.S. imported $213 billion worth of medicines in 2024 — from China but also India, Europe, and other areas.

Prescription drugs sit ready to be distributed to patients at 986 Pharmacy in Alhambra, California. ((Jackie Fortiér/KFF Health News)/KFF Health News/TNS)

Trump’s statement sent drugmakers scrambling to figure out whether he was serious, and whether some tariffs would be levied more narrowly, since many parts of the U.S. drug supply chain are fragile, drug shortages are common, and upheaval at the FDA leaves questions about whether its staffing is adequate to inspect factories, where quality problems can lead to supply chain crises.

On May 12, Trump signed an executive order asking drugmakers to bring down the prices Americans pay for prescriptions, to put them in line with prices in other countries.

Meanwhile, pharmacists predict even the 10% tariffs Trump has demanded will hurt: Jolley said a potential increase of up to 30 cents a vial is not a king’s ransom, but it adds up when you’re a small pharmacy that fills 50,000 prescriptions a year.

“The one word that I would say right now to describe tariffs is ‘uncertainty,’” said Scott Pace, a pharmacist and owner of Kavanaugh Pharmacy in Little Rock, Arkansas.

To weather price fluctuations, Pace stocked up on the drugs his pharmacy dispenses most.

“I’ve identified the top 200 generics in my store, and I have basically put 90 days’ worth of those on the shelf just as a starting point,” he said. “Those are the diabetes drugs, the blood pressure medicines, the antibiotics — those things that I know folks will be sicker without.”

Pace said tariffs could be the death knell for the many independent pharmacies that exist on “razor-thin margins” — unless reimbursements rise to keep up with higher costs.

Unlike other retailers, pharmacies can’t pass along such costs to patients. Their payments are set by health insurers and pharmacy benefit managers largely owned by insurance conglomerates, who act as middlemen between drug manufacturers and purchasers.

Neal Smoller, who employs 15 people at his Village Apothecary in Woodstock, New York, is not optimistic.

“It’s not like they’re gonna go back and say, well, here’s your 10% bump because of the 10% tariff,” he said. “Costs are gonna go up and then the sluggish responses from the PBMs — they’re going to lead us to lose more money at a faster rate than we already are.”

Smoller, who said he has built a niche selling vitamins and supplements, fears that FDA firings will mean fewer federal inspections and safety checks.

“I worry that our pharmaceutical industry becomes like our supplement industry, where it’s the wild West,” he said.

Pills sit in the tray of a pill-counting machine at 986 Pharmacy in Alhambra, California. ((Jackie Fortiér/KFF Health News)/KFF Health News/TNS)

Narrowly focused tariffs might work in some cases, said Marta Wosińska, a senior fellow at the Brookings Institution’s Center on Health Policy. For example, while drug manufacturing plants can cost $1 billion and take three to five years to set up, it would be relatively cheap to build a syringe factory — a business American manufacturers abandoned during the covid-19 pandemic because China was dumping its products here, Wosińska said.

It’s not surprising that giants such as Novartis and Eli Lilly have promised Trump they’ll invest billions in U.S. plants, she said, since much of their final drug product is made here or in Europe, where governments negotiate drug prices. The industry is using Trump’s tariff saber-rattling as leverage; in an April 11 letter, 32 drug companies demanded European governments pay them more or face an exodus to the United States.

Brandon Daniels, CEO of supply chain company Exiger, is bullish on tariffs. He thinks they could help bring some chemical manufacturing back to the U.S., which, when coupled with increased use of automation, would reduce the labor advantages of China and India.

“You’ve got real estate in North Texas that’s cheaper than real estate in Shenzhen,” he said at an economic conference April 25 in Washington, referring to a major Chinese chemical manufacturing center.

But Wosińska said no amount of tariffs will compel makers of generic drugs, responsible for 90% of U.S. prescriptions, to build new factories in the U.S. Payment structures and competition would make it economic suicide, she said.

Several U.S. generics firms have declared bankruptcy or closed U.S. factories over the past decade, said John Murphy, CEO of the Association for Accessible Medicines, the generics trade group. Reversing that trend won’t be easy and tariffs won’t do it, he said.

“There’s not a magic level of tariffs that magically incentivizes them to come into the U.S.,” he said. “There is no room to make a billion-dollar investment in a domestic facility if you’re going to lose money on every dose you sell in the U.S. market.”

His group has tried to explain these complexities to Trump officials, and hopes word is getting through. “We’re not PhRMA,” Murphy said, referring to the powerful trade group primarily representing makers of brand-name drugs. “I don’t have the resources to go to Mar-a-Lago to talk to the president myself.”

Many of the active ingredients in American drugs are imported. Fresenius Kabi, a German company with facilities in eight U.S. states to produce or distribute sterile injectables — vital hospital drugs for cancer and other conditions — complained in a letter to U.S. Trade Representative Jamieson Greer that tariffs on these raw materials could paradoxically lead some companies to move finished product manufacturing overseas.

Fresenius Kabi also makes biosimilars, the generic forms of expensive biologic drugs such as Humira and Stelara. The United States is typically the last developed country where biosimilars appear on the market because of patent laws.

Tariffs on biosimilars coming from overseas — where Fresenius makes such drugs — would further incentivize U.S. use of more expensive brand-name biologics, the March 11 letter said. Biosimilars, which can cost a tenth of the original drug’s price, launch on average 3-4 years later in the U.S. than in Canada or Europe.

In addition to getting cheaper knockoff drugs faster, European countries also pay far less than the United States for brand-name products. Paradoxically, Murphy said, those same countries pay more for generics.

European governments tend to establish more stable contracts with makers of generics, while in the United States, “rabid competition” drives down prices to the point at which a manufacturer “maybe scrimps on product quality,” said John Barkett, a White House Domestic Policy Council member in the Biden administration.

As a result, Wosińska said, “without exemptions or other measures put in place, I really worry about tariffs causing drug shortages.”

Smoller, the New York pharmacist, doesn’t see any upside to tariffs.

“How do I solve the problem of caring for my community,” he said, “but not being subject to the emotional roller coaster that is dispensing hundreds of prescriptions a day and watching every single one of them be a loss or 12 cents profit?”

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

Not so long ago, Lillian Kahan would’ve been an oddity.

She’s 104 years old (“104 and a half,” she corrects), and, until recently, a life of such length was a statistical quirk, rare enough to warrant news coverage or scientific research or at least a cupcake at the local senior center.

These days that’s only half true. Kahan’s age still makes news, and scientists increasingly are interested in people like her. She still gets the odd cupcake.

But the attention isn’t coming because she’s so uncommon. It’s because she’s not.

In fact, being a Kahan – living to 100 and beyond – might be a glimpse of the future.

“Being this old is fun,” Kahan said. “I recommend it.”

Welcome to Ageville

The number of centenarians worldwide has more than doubled over the past 25 years and demographers at the United Nations project that the 100-something crowd will quadruple by mid-century. Today, the biggest centenarian populations are in Japan (146,000) and the United States (108,000). But, soon, countries like China and India, where the overall populations are huge but the aging curve is only now starting to trend upward, will have even bigger 100-something age bubbles. By 2054, nearly 4 million people around the world will be 100 or older.

The trend is expected to be even more pronounced locally. The state projects that from now until 2050, the ranks of centenarians will jump more than fivefold in each of Los Angeles, Orange, Riverside and San Bernardino counties.

Of course, centenarians are just the tip of a bigger demographic spear.

Populations are aging up in most advanced economies, at a rate never before seen in human history. In many countries, older people already outnumber children or they’re expected to in the near future. Aging demographics are reshaping everything from retirement plans and immigration patterns to diaper sales and popular ideals about beauty.

Like many aspects of the aging boom, the rise of centenarians is a mixed bag.

For example, it’s unambiguously good that lifestyle changes and cancer prevention and medical sciences have all improved enough to make it possible for so many people to live so long and, often, so well.

“Every centenarian I’ve met is exceptional,” said Stacy Andersen, who, as co-director of the New England Centenarian Study at Boston University, has met a lot of centenarians.

“These people have delayed chronic, age-related diseases. That’s the baseline. But many also continue to live vibrant lives, to stay engaged in their community and with their families,” she added. “It’s a wonderful view of what aging can be.”

It’s also unambiguously great that younger relatives and friends – everybody under 100, really – can, if they listen, pick up some life hacks that come with living 100 or more years.

“I still love waking up,” said Kahan, her New York accent still thick after six-plus decades in Mission Viejo and other parts of Southern California.

“You should try to do that. It’s pretty important.”

But good things often come with a cost, and the rise of centenarians presents some huge challenges.

Money, health, family hassles; the same issues that plague younger people don’t go away when someone turns 100. But the ability to leap over those hurdles – or, perhaps, to worry about them at all – drops considerably when you become a centenarian.

“I don’t necessarily want to make it to 100,” said Margo Carle, an ombudsman with the Council on Aging Southern California who works as an independent advocate for older people who live in nursing homes and other facilities.

“I see too much of how it can be,” Carle said.

“If you don’t have money, being 100 can be … Well, it’s not always pretty.”

Stresses for all

For Kahan and her 100-something cohorts, the cost of living isn’t cheap.

Though studies show centenarians generally are more physically robust than other older people, age is still age. About half of the 100-something crowd in the United States has some form of dementia, and most of those people need full-time care.

And even among those with little or no cognitive decline, only a small fraction can live on their own without someone – paid or otherwise – checking in every day to help them.

“My sons are all teachers. And they’ve arranged their schedules, they rotate, so they can stay with me,” said Rudolph Marcus, a 101-year-old chemist and former Caltech professor who won the Nobel Prize for Chemistry in 1992.

“That helps me continue with my work,” Marcus said. “I still think about my work every day, to be honest. Some problems I can still solve, some I can’t.

“But I could not do any of that without their help.”

Marcus, who won the Nobel for his work on how electrons jump from atom to atom (something that affects the functionality of solar panels and electric cars, among other things), is an outlier. He lives in the same Pasadena house he shared with his late wife, Laura, who died in 2003. Most people his age live in some kind of congregate setting, which in Southern California can run $5,000 to $15,000 a month.

Given that many newly minted centenarians have outlived their retirement savings, or didn’t have much to begin with, the cost of that care often falls to families and the government.

Soon, half of that equation might change.

A proposal being debated in Congress this month could include big cuts to Medicaid, the federal program that helps pay the costs of long-term care for, among others, centenarians. Those cuts, if passed, could result in lower-quality care or, in some cases, displacement. Other proposed Medicaid adjustments could reduce compensation for in-home care, making it tough for centenarians to live without family help.

For families who don’t want to hire out, or who can’t, the costs of centenarian care can run deeper than money.

Unlike younger retirees, whose adult children typically are young enough to still be working, the children of centenarians often are aged themselves – typically in their 70s or 80s. For them, providing care for an aging parent can be devastating, financially and otherwise.

“In many of the cultures that are common in Los Angeles, it’s an honor to care for your aging relatives,” said Heather Cooper Ortner, chief executive of Alzheimer’s Los Angeles, a nonprofit that helps provide services to people and families battling dementia.

“So it isn’t about people being unwilling to do this, or seeing it as a burden. That’s not always the case,” she said.

“But caring for older people can present an incredible level of stress for family caregivers,” Cooper Ortner added. Food, medical questions and appointments, bathing, bathroom help, fall prevention – caring for a centenarian is, literally, a full-time job. For a child in her 80s, it can be too much.

“It’s not uncommon to see a caregiver pass away before the person they’re caring for,” Cooper Ortner said.

“It’s a very complicated dynamic.”

Survive, delay, escape

The first public service messages warning Americans that smoking causes cancer started airing on television in 1967. A few years later, jogging became a national craze and, over the next two decades, about 25 million Americans started going for a run as a regular part of their lives. Less red meat. More sunblock. Meditation. All of it means one thing:

If you’re on deck to turn 100 this year, you’ve spent about half your life in a world where the phrase “healthy lifestyle” wasn’t a punchline.

It’s one reason, though not the biggest, that explains why so many people are living so long. People who study centenarians – and there are hundreds of aging experts looking into the topic in the United States, Japan and Europe – say genetics and the sheer power of population numbers are even bigger factors.

“At the turn of the last century, life expectancy was about 50. But a lot of things – cleaner water, prevention of infant deaths, antibiotics – made it so a lot more people made it into adulthood. That just means there are a lot more people who are going to have the opportunity to hit 100,” said Andersen, of the New England Centenarian Study.

But at least one projection suggests population numbers alone are only part of the broader trend. Even as more people, overall, hit 100, the ratio of people who reach that age is skyrocketing. According to United Nations data, Japan currently has about 12 centenarians for every 10,000 residents (the ratio in the U.S. is about 3 in 10,000). By 2050, the ratio in Japan will be about 40 out of every 10,000, and in the U.S., it’ll be about 14 out of 10,000.

“Having good, healthy habits can get you about 10 years longer. And it definitely makes those years better, which is important,” Andersen said. “But it doesn’t necessarily get you to 100.”

Genes might.

Andersen said there is no single “centenarian gene.” Instead, researchers have identified about 200 different genes to date that do age-related things like reduce inflammation and boost immune systems. People who have certain combinations of those genes have significantly better odds of making it to 100.

“We’re still trying to understand the relationships between protective genes,” Andersen said. “But it’s more about genetics than we once believed. And we’re learning more about that all the time.”

The New England Centenarian Study, which started in 1994, has tracked the lives of more than 1,800 centenarians, including 123 so-called “supercentenarians,” meaning people who made it to 110 or older. It’s also looked at more than 600 of their children, and more than 400 so-called “controlled” subjects, (usually spouses and relatives of spouses), as a way to identify the balance between genetics, lifestyle and other factors when it comes to cracking 100.

They’ve learned, so far, that so-called “exceptional longevity” – meaning the likelihood of making it to 100 — runs in families. They’ve also learned that many people who tend to live so long hit age-related illnesses later in life, and that they often compress their debilitations into shorter windows.

“Centenarians spend about 10% of their lives with a chronic illness. Others spend about 20% of their lives in that kind of situation, on average,” Andersen said.

The study has identified three basic types of centenarians. About 4 in 10 (43%) are “delayers,” meaning they didn’t experience age-related diseases, like dementia, until age 80 or later. Another 4 in 10 (42%) are “survivors,” meaning they made it to 100 even though they’ve been battling some kind of disease since before their 80th birthday. And about 1 in 7 (15%) are “escapers,” or people who, even at 100, don’t have any age-related disease.

Marcus, the chemist from Caltech, is probably an escaper.

“I don’t play tennis anymore. And I don’t ski. My sight doesn’t really allow it. But otherwise I feel pretty much the same,” he said.

When asked if he’s still learning about himself, at age 101, or if he’s got any advice to someone hoping to live well at his age, Marcus said yes and demurred.

“I’m learning every day. I try to live in the moment. I’d like to think I don’t live in the past and I never thought too much about the future, even when I was younger. And I definitely don’t do it now, at my age,” Marcus said, laughing.

“But I wouldn’t know if that’s what other people should or shouldn’t do,” he added. “It’s just the way I’ve always been.”

Kahan is probably a delayer. She doesn’t have dementia, but she said she battles health issues she declined to offer in detail.

She did offer one tip.

“Every day. I watch some TV, I talk with my friend. I enjoy my day,” Kahan said.

“But time passes very quickly,” she added. “Even at my age, it doesn’t slow down. And I think that means something.”

Anyone interested in participating in the New England Centenarian Study can call 888-333-6327 or email agewell@bu.edu.

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By Robbie Sequeira, Stateline.org

In the wake of President Donald Trump’s executive order aiming to reinstate “common sense” school discipline, more states may follow and expand the authority of teachers and school officials to deal with disruptive students.

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The order, signed in April, repeals prior federal guidance that encouraged schools to address racial disparities in discipline, arguing that such policies promoted “discriminatory equity ideology” and compromised school safety by pressuring administrators to underreport serious student misconduct.

In some states, new legislation already is trending toward giving teachers more authority to address student misbehavior.

In West Virginia, for example, a new law creates a structured process for responding to violent, threatening or disruptive behavior among students in grades K-6.

Under the law, a student exhibiting such behavior can be immediately removed from class, evaluated by counselors or behavioral specialists and placed on an individualized behavior plan. If there’s no improvement after two rounds of intervention, the student could be moved into a behavioral intervention program or an alternative learning environment.

West Virginia Gov. Patrick Morrisey, a Republican, and supporters say the law empowers teachers to maintain safe classrooms.

“This legislation provides teachers with the tools to regain control of the classroom and ensure safe learning environments for our kids,” Morrisey said at the bill’s signing.

In April, the Texas House of Representatives passed a bill referred to as the “Teacher’s Bill of Rights” with a bipartisan vote of 124-20.

That bill, now sitting in the Senate’s education committee, would significantly expand the grounds for out-of-school suspensions, allowing students to be suspended for repeated disruptions or threats beginning in third grade. It would reverse earlier changes that limited suspensions for younger students. It also would mandate that students making terroristic threats or assaulting school employees be placed in alternative education programs for at least 30 days.

Texas civil rights groups argue that the bill would impose a one-size-fits-all punitive approach, rather than addressing students’ developmental and behavioral needs.

Alycia Castillo, associate director of policy at the Texas Civil Rights Project and a former teacher, said state lawmakers are taking the wrong approach by mandating sweeping discipline policies for a state as diverse as Texas.

During the 2020-21 school year, according to the latest data available from the U.S. Department of Education, Black students faced the highest rates of disciplinary action across all categories — suspension and expulsion — among all racial and ethnic groups.

They were 39% more likely than white students to receive in-school suspensions, 70% more likely to face out-of-school suspensions, and 71% more likely to be expelled.

The disparities were even starker for Black students with disabilities, who experienced suspension and expulsion rates far exceeding those of both their white peers and non-disabled students.

Reviving old, harsh disciplinary policies risks disproportionately harming students of color, students with disabilities and those from low-income backgrounds, Castillo said.

“What works in Austin may not work in West Texas,” Castillo said.

“Children are naturally disruptive — that’s part of their development,” she added. “Excluding them only harms their growth into functional adults.”

Restorative justice models

In recent years, some other states have passed laws promoting restorative practices in schools, in which students and teachers work through problems and focus on repairing the harm caused by disruptions or conflict.

Michigan’s 2017 law requires schools to consider restorative approaches before suspensions or expulsions, aiming to repair harm rather than exclude students. Nevada began mandating restorative justice approaches in 2019, but scaled back that approach in 2023.

This year, Maryland passed a law requiring the state to establish “restorative practices schools,” specific schools with trained educators who use the approach in everyday discipline.

Kimberly Hellerich, an assistant professor at Sacred Heart University and a former K-12 teacher, said discipline policies should go beyond punitive measures to foster accountability and community healing.

“Adding restorative practices to accompany codes of conduct can allow students to recognize the impact of their actions on themselves, peers, the teacher, the class and the school community,” Hellerich said.

In her own classrooms, Hellerich used what she called “community circles” to guide students in processing behavior, offering apologies and rebuilding trust. “The apology served as a way to restore the student’s relationship with the entire class community,” she said.

Calls for a cultural shift on expectations

While lawmakers debate discipline procedures, other education advocates warn that an even deeper issue is unfolding inside classrooms: the gradual erosion of behavioral expectations and academic rigor.

Jessica Bartnick, co-founder and CEO of the Dallas-based mentorship program Foundation for C.H.O.I.C.E., said that declining school discipline and lowered standards are quietly undermining educational outcomes.

“Discipline is the backbone of effective learning,” Bartnick, who supports the Texas legislation, told Stateline in an email. “Without it, classrooms become chaotic, instructional time is lost and teachers are forced to shift their focus from instruction to behavior management.”

Bartnick said efforts to promote equity sometimes inadvertently lower behavioral standards and deprive teachers of the tools they need to maintain safe learning environments.

She also criticized lenient grading policies and unlimited test retakes, arguing that they diminish the value of preparation, responsibility and resilience.

“If students are shielded from the discomfort of failure, they are also shielded from the growth that comes with it,” she wrote. “If we want to prepare students for a world that will not offer endless second chances, we must return to a classroom culture grounded in discipline, responsibility, and rigor.”

Stateline reporter Amanda Hernández contributed to this report. Stateline reporter Robbie Sequeira can be reached at rsequeira@stateline.org.

©2025 States Newsroom. Visit at stateline.org. Distributed by Tribune Content Agency, LLC.

By Kevin Hardy, Stateline.org

In submitting her updated budget proposal in March, Arizona Gov. Katie Hobbs lamented the rising costs of the state’s school vouchers program that directs public dollars to pay private school tuition.

Characterizing vouchers as an “entitlement program,” Hobbs said the state could spend more than $1 billion subsidizing private education in the upcoming fiscal year. The Democratic governor said those expenses could crowd out other budget priorities, including disability programs and pay raises for firefighters and state troopers.

It’s a dilemma that some budget experts fear will become more common nationwide as the costs of school choice measures mount across the states, reaching billions of dollars each year.

“School vouchers are increasingly eating up state budgets in a way that I don’t think is sustainable long term,” said Whitney Tucker, director of state fiscal policy research at the Center on Budget and Policy Priorities, a think tank that advocates for left-leaning tax policies.

Vouchers and scholarship programs, which use taxpayer money to cover private school tuition, are part of the wider school choice movement that also includes charter schools and other alternatives to public schools.

Opponents have long warned about vouchers draining resources from public education as students move from public schools to private ones. But research into several programs has shown many voucher recipients already were enrolled in private schools. That means universal vouchers could drive up costs by creating two parallel education systems — both funded by taxpayers.

In Arizona, state officials reported most private school students receiving vouchers in the first two years of the expanded program were not previously enrolled in public schools. In fiscal year 2024, more than half the state’s 75,000 voucher recipients were previously enrolled in private schools or were being homeschooled.

“Vouchers don’t shift costs — they add costs,” Joshua Cowen, a professor of education policy at Michigan State University who studies the issue, recently told Stateline. “Most voucher recipients were already in private schools, meaning states are paying for education they previously didn’t have to fund.”

Voucher proponents, though, say those figures can be misleading. Arizona, like other states with recent expansions, previously had more modest voucher programs. So some kids who were already enrolled in private schools could have already been receiving state subsidies.

In addition to increasing competition, supporters say the programs can actually save taxpayer dollars by delivering education at a lower overall cost than traditional public schools.

One thing is certain: With a record number of students receiving subsidies to attend private schools, vouchers are quickly creating budget concerns for some state leaders.

The rising costs of school choice measures come after years of deep cuts to income taxes in many states, leaving them with less money to spend. An end of pandemic-era aid and potential looming cuts to federal support also have created widespread uncertainty about state budgets.

“We’re seeing a number of things that are creating a sort of perfect storm from a fiscal perspective in the states,” said Tucker, of the Center on Budget and Policy Priorities.

Last year, Arizona leaders waded through an estimated $1.3 billion budget shortfall. Budget experts said the voucher program was responsible for hundreds of millions of that deficit.

A new universal voucher program in Texas is expected to cost $1 billion over its next two-year budget cycle — a figure that could balloon to nearly $5 billion by 2030, according to a legislative fiscal note.

Earlier this year, Wyoming Republican Gov. Mark Gordon signed a bill expanding the state’s voucher program. But last week, he acknowledged his own “substantial concerns” about the state’s ability to fund vouchers and its public education obligations under the constitution.

“I think the legislature’s got a very tall task to understand how they’re going to be able to fund all of these things,” he said in an interview with WyoFile.

Voucher proponents, who have been active at the state level for years, are gaining new momentum with support from President Donald Trump and congressional Republicans.

In January, Trump ordered federal agencies to allow states, tribes and military families to access federal money for private K-12 education through education savings accounts, voucher programs or tax credits.

Last week, Republicans on the House Ways and Means Committee voted in favor of making$20 billion available over the next four years for a federal school voucher program. Part of broader work on a bill to extend Trump’s 2017 tax cuts, the measure would need a simple majority in the House and the Senate to pass.

Martin Lueken, the director of the Fiscal Research and Education Center at EdChoice, a nonprofit that advocates for school choice measures, argues school choice measures can actually deliver savings to taxpayers.

Lueken said vouchers are not to blame for state budget woes. He said public school systems for years have increased spending faster than inflation. And he noted that school choice measures make up a small share of overall state spending — nationally about 0.3% of total state expenditures in states with school choice, he said.

“Public schooling remains one of the largest line items in state budgets,” he said in an interview. “They are still the dominant provider of K-12 education, and certainly looking at the education pie, they still receive the lion’s share.

“It’s not a choice problem. I would say that it’s a problem with the status quo and the public school system,” he said.

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Washington, D.C., and 35 states offer some school choice programs, according to EdChoice. That includes 18 states with voucher programs so expansive that virtually all students can participate regardless of income.

But Lueken said framing vouchers as a new entitlement program is misleading. That’s because all students, even the wealthiest, have always been entitled to a public education — whether they’ve chosen to attend free public schools or private ones that charge tuition.

“At the end of the day, the thing that matters most above dollars are students and families,” he said. “Research is clear that competition works. Public schools have responded in very positive ways when they are faced with increased competitive pressure from choice programs.”

Public school advocates say funding both private and public schools is untenable.

In Wisconsin, Republican lawmakers are considering a major voucher expansion that would alter the funding structure for vouchers, potentially putting more strain on the state’s general fund.

The state spent about $629 million on its four voucher programs during the 2024-2025 school year, according to the Wisconsin Association of School Business Officials, which represents employees in school district finance, human resources and leadership.

The association warns proposed legislation could exacerbate problems with the “unaffordable parallel school systems” in place now by shifting more private schooling costs from parents of those students to state taxpayers at large.

Such expansion “could create the conditions for even greater funding challenges for Wisconsin’s traditional public schools and the state budget as a whole,” the association’s research director wrote in a paper on the issue.

In Arizona, Hobbs originally sought to eliminate the universal voucher program — a nonstarter in the Republican-controlled legislature. She has since proposed shrinking the program by placing income limits that would disqualify the state’s wealthiest families.

That idea also faced Republican opposition.

Legislators are now pushing to enshrine access to vouchers in the state constitution.

Marisol Garcia, president of the Arizona Education Association, the state’s 20,000-member teachers union, noted that vouchers and public education funds are both sourced from the general fund.

“So it almost immediately started to impact public services,” she said of the universal voucher program.

While the union says vouchers have led to cutbacks of important resources such as counselors in public schools, Garcia said the sweeping program also affects the state’s ability to fund other services like housing, transportation and health care.

“Every budget cycle becomes where can we cut in order to essentially feed this out-of-control program?” she said.

Stateline reporter Kevin Hardy can be reached at khardy@stateline.org.

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