Roger Marshall and the One Big Beautiful Bill Act: His Vote, the Rural Hospital Votes, and Kansas Medicaid and SNAP Losses

Roger Marshall, the Republican U.S. senator from Kansas, cast one of the 50 votes for the One Big Beautiful Bill Act on July 1, 2025, a law the Congressional Budget Office says will cut federal health spending by more than $1 trillion and leave 10 million more people uninsured. The bill passed 50 to 50, with the Vice President breaking the tie, so it would have failed without his vote. The CBO figures are summarized by KFF. In Kansas, the REACH Healthcare Foundation estimated the state stands to lose $3.897 billion in Medicaid funding and 13,000 Kansans their Medicaid coverage.

Before final passage, Marshall voted against every motion on June 30, 2025 that would have stripped or softened the bill's health and food cuts, including a motion to protect rural hospitals that failed 49 to 51. After the vote he said the law means "we are entering America's golden era," and he said it would "help shrink the debt," a claim the Kansas Reflector reported conflicted with a congressional estimate that it adds at least $3.3 trillion to the debt.

One year later, Kansas groups reported that 24,000 Kansans had lost SNAP benefits, including 11,000 children, and that the state budget faced at least $16.4 million in new SNAP costs.

Roger Marshall's Votes and Statements on the One Big Beautiful Bill Act, in the Order the Bill Moved

• Marshall Voted for the First 2025 Budget Plan That Set Up the Cuts. On February 21, 2025, Roger Marshall voted for the Senate's fiscal year 2025 budget resolution, S.Con.Res. 7, adopted 52 to 48. Earlier that day he voted against an amendment to strike reconciliation instructions requiring cuts to programs critical to rural Americans and food assistance, which failed 47 to 53, and against a point of order on legislation that would reduce Medicare and Medicaid benefits, which failed 49 to 51.
• Marshall Voted for the April 2025 Budget Resolution After Rejecting Medicaid and Rural Hospital Protections. On April 5, 2025, Marshall voted for H.Con.Res. 14, the budget resolution whose instructions produced the law, adopted 51 to 48. Before that he voted against a reserve fund to prevent Medicaid cuts that could lead to rural hospital closures, which failed 49 to 50, against striking the Agriculture Committee's cut instructions, which failed 47 to 51, and against a reserve fund to prevent reductions in Medicaid enrollment or benefits, which failed 48 to 51.
• Marshall Voted Against Protecting Rural Hospitals From the Bill on June 30, 2025. On June 30, 2025, Marshall voted no on Senator Ed Markey's motion to commit the bill with instructions on rural hospitals, which failed 49 to 51. The same day he voted against Senator Ron Wyden's motion to strike the Medicaid cuts (47 to 53), a motion on red tape (48 to 52), a motion on SNAP (49 to 51), a motion on state provider taxes (48 to 52) and a motion on Medicaid and hospital labor and delivery units (48 to 52), as recorded in the Senate floor log.
• Marshall Voted to Waive a Point of Order Against the Bill's SNAP Cost Shift to States. On June 30, 2025, Marshall voted yes on the motion to waive the Budget Act against Senator Amy Klobuchar's point of order that the bill's SNAP provisions were an unfunded mandate on the states; the motion passed 51 to 48. Starting October 1, 2027, most states must pay a share of SNAP benefit costs for the first time, and CBPP estimates Kansas would owe about $40 million in fiscal year 2028.
• Marshall Voted Against Extending the Health Insurance Tax Credits in the Bill. On June 30, 2025, Marshall voted no on waiving the Budget Act for Senator Jon Ossoff's amendment to extend the enhanced premium tax credits and raise the tax rate on income over $10 million; it failed 47 to 53. After the credits expired, Kansans with marketplace coverage fell 20 percent between February 2025 and February 2026.
• Marshall Voted Against Medicare Dental, Vision and Hearing Coverage. On July 1, 2025, Marshall voted no on Senator Bernie Sanders's amendment to cut Medicare drug prices in half and cover dental, vision and hearing, which failed 47 to 53.
• Marshall Cast a Deciding Vote for the Final Bill. On July 1, 2025, Marshall voted yes on final passage of H.R. 1, which passed 50 to 50 with the Vice President's tie-breaking vote, according to the Senate floor log. CBO estimates the law reduces federal health spending by more than $1 trillion and increases the number of uninsured people by 10 million, KFF reports.
• Marshall Defended the Medicaid Cuts on the Senate Floor as Increasing Funding. On June 30, 2025, during the vote series, Marshall said on the Senate floor, "We're increasing funding for Medicaid," and urged senators to vote no on the pending amendment. CBO estimates the law's Medicaid changes reduce federal Medicaid spending by $911 billion over 2025 to 2034 and increase the number of uninsured people by 7.5 million in 2034.
• Marshall Said the Law Would Help Shrink the Debt. After the Senate vote on July 1, 2025, Marshall said the legislation would "help shrink the debt," a claim the Kansas Reflector reported conflicted with a congressional budget estimate that the bill would add at least $3.3 trillion to the debt over the next decade.
• Marshall Called the Bill the Start of a Golden Age. In a July 1, 2025 statement, Marshall said, "This is just the beginning of America's great Golden Age," and urged the House to send the bill to the President by July 4. He also told reporters the law "will deliver a win for every single American."

What the One Big Beautiful Bill Act Roger Marshall Voted For Means for Kansas

• Kansas stands to lose nearly $3.9 billion in Medicaid funding. The REACH Healthcare Foundation estimated Kansas will lose $3.897 billion in federal and state Medicaid funding under the Senate-passed bill, including $2.65 billion for Kansas hospitals over 10 years, money that pays for care at hospitals already short of revenue.
• Tens of thousands of Kansans have lost food assistance. Kansas Appleseed reported that 24,000 Kansans, including 11,000 children, lost SNAP benefits in the law's first year, which it attributed to expanded work requirements and paperwork barriers; children who lose SNAP also lose the automatic enrollment in free school meals that SNAP provides, Kansas Appleseed warned.
• Kansas rural hospitals face the highest closure risk in the country. Kansas has more rural hospitals at risk of closure than any other state, with 67 of 100 at risk and 30 at immediate risk, according to the Center for Healthcare Quality and Payment Reform data Kansas Public Radio reported in October 2025.
• Kansas families paid more for health coverage after the tax credits lapsed. Nationally, average ACA marketplace premium payments rose 58 percent, from $113 to $178 a month, in 2026, and many Kansans who kept coverage switched to plans with higher out-of-pocket costs.

Frequently Asked Questions About Roger Marshall on One Big Beautiful Bill

Last updated: 2026-10-28

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