Ann Wagner and the One Big Beautiful Bill Act: Seven Margin-Making Votes, a Yes on Final Passage, and $14.3 Billion Gone From Missouri Medicaid

Reconciliation runs in two steps, a budget resolution that hands each committee a dollar target and then a bill written to those targets, and Ann Wagner, Republican of Missouri's 2nd District, was the margin at both: the February and April 2025 resolution votes, the House's 215 to 214 passage on May 22, 2025, and four procedural votes on rules. On July 3 she voted for final passage. Missouri's slice of the Medicaid cut that followed, as KFF allocates it, is $14.3 billion over ten years.

KFF expects 160,000 more Missourians to lack insurance in 2034 as a result, and CBPP found in June 2025 that 34,000 Missouri adults were exposed to the Senate Agriculture Committee's version of the wider SNAP time limit the law adopted. In April 2026, Wagner added her vote to a House resolution celebrating the law's tax side.

Ann Wagner's House Votes on the One Big Beautiful Bill Act, Roll by Roll

• February 25, 2025: Wagner's Vote Was the Margin on the Budget Plan That Gave the Medicaid and SNAP Committees Their $880 Billion and $230 Billion Savings Targets. Three Wagner yeses that day: roll 46, the previous-question motion on H.Res. 161, the procedural rule for floor debate of the plan; roll 47, adopting that rule; roll 50, adopting H.Con.Res. 14, 217 to 215. Had she alone voted no on that last one, the count would have tied at 216, and the plan would have failed. Its targets: Energy and Commerce, the Medicaid committee, to reduce the deficit by "not less than $880,000,000,000"; Agriculture, the SNAP committee, at least $230 billion; and Ways and Means free to add as much as $4.5 trillion to deficits for tax cuts.
• April 9 and 10, 2025: Wagner Was the Margin on the Rule and on the Senate-Amended Budget Plan. Roll 93, April 9: yes on the previous question for H.Res. 313. Roll 94, same day: yes on that rule, which took up the Senate's amended resolution and carried 216 to 215. Roll 100, April 10: yes on concurring in the Senate version, 216 to 214. A lone switch by Wagner sinks the rule outright and ties the resolution, which also sinks it. The committee targets survived intact. The final law, passed July 3, carries Medicaid reductions the Congressional Budget Office prices at $911 billion over a decade, per KFF.
• May 22, 2025: Wagner's Yes Passed a House Bill That Would Have Barred Planned Parenthood From Medicaid for Ten Years. Six roll calls on H.R. 1 that day, Wagner's position on each: rolls 139 and 140, yes on considering the rule, H.Res. 436 (217 to 211; 216 to 211); roll 141, the previous question, which carried 213 to 211 with her as the deciding yes; roll 142, yes on the rule; roll 144, a 212 to 216 defeat for the motion to recommit, which she voted against; roll 145, yes on passage, 215 to 214 with one present, again the margin. Wagner voted for a version that would have cut off Medicaid payments to Planned Parenthood for care "furnished during the 10-year period beginning on the date of the enactment of this Act"; the final law made it one year, and in that year nearly 30 of the group's health centers closed, Planned Parenthood reported. The Medicaid provisions that became law raise the 2034 uninsured count by 7.5 million, by the Congressional Budget Office's estimate as reported by KFF.
• July 2 and 3, 2025: Wagner Was the Margin on Two Rule Votes, Then Voted for Final Passage. On the rule for the Senate's text, H.Res. 566, Wagner voted yes on roll 186, consideration, 212 to 211, and roll 187, the previous question, 214 to 212; her switch alone would have defeated roll 186 and tied roll 187, and a tied vote fails. She also voted yes on roll 188, an amendment to the rule offered by Rep. Foxx (220 to 212), and roll 189, the rule (219 to 213). Roll 190, July 3, was final passage, 218 to 214, Wagner voting yes; enactment followed on July 4, 2025 (Public Law 119-21). Ten million more people will be uninsured in 2034 under the enacted law, in a Congressional Budget Office projection that KFF relays, and "The megabill cuts SNAP by $187 billion or about 20 percent by 2034," according to the Center on Budget and Policy Priorities.
• April 16, 2026: Wagner Voted for a Resolution Calling the Law the Working Families Tax Cuts. Roll 121 of 2026: Wagner yes as H.Res. 1156 passed 219 to 207. The text dubs the law the "Working Families Tax Cuts" and claims it "will result in a 15 percent tax cut for Americans whose income is in the bottom 40 percent." ITEP's 2026 numbers say otherwise for the bottom: "For the poorest fifth of Americans, the average tax change from OBBBA is a small tax increase," and the richest 1 percent see an average cut topping $70,000.

What the Law Ann Wagner Voted For Costs Missouri, Topic by Topic

• Medicaid: Missouri gives up $14.3 billion, 12% of its expected federal funding. By KFF's allocation, Missouri's federal Medicaid money falls $14.3 billion over ten years, 12% of the expected total, and that money pays for care for the 75,500 enrollees in Missouri's 2nd District among others. Votes and details: Ann Wagner's health care page.
• Coverage: 160,000 additional Missourians uninsured by 2034. KFF's projection from the law alone; each of those Missourians pays for care out of pocket or goes without. See the health care page.
• Work rule: 24,400 expansion adults in Wagner's district must report hours. Missouri expanded Medicaid, so the 80-hour monthly rule covers its expansion adults, 24,400 in the 2nd District, beginning no later than January 1, 2027. Details are on the health care page.
• Rural care: a $4.53 billion cut in rural Missouri's federal Medicaid spending. KFF tallies $4.53 billion less federal Medicaid spending in rural Missouri over ten years, so small-town hospitals have less to keep units staffed. The health care page covers the hospital limits.
• SNAP: CBPP's June 2025 estimate put 34,000 Missouri adults at risk of losing food aid. CBPP's June 2025 Missouri estimate, built on Senate Agriculture Committee language containing both expansions the law made: 14,000 Missourians between 55 and 64 and 20,000 whose youngest child is at least 14 could lose SNAP in a typical month under that stretched time limit. Ann Wagner's food assistance page has the votes.
• Medicare: 1.33 million Missouri enrollees and a hospital fund now depleted a quarter sooner, in 2033. Missouri counted 1,331,378 Medicare enrollees in 2024; with less benefit-tax revenue, the hospital trust fund is now projected to run out in 2033, one quarter earlier than the prior forecast, when payments face an 11% cut. More on the Medicare page.
• Nursing homes: Medicaid is first payer for 65% of Missouri residents, and 1,835 wait for home care. Of Missouri's 34,837 nursing-facility residents, 65% rely on Medicaid as primary payer, and 1,835 Missourians were on Medicaid home-care waiting lists in 2026, both funded by the program the provider-tax and payment caps shrink. The elder care page has more.
• Disability: 7,200 disabled Medicaid enrollees in Wagner's district rely on a program the law cuts, and disabled expansion adults the state misses must report hours. Medicaid serves 7,200 people with disabilities in Missouri's 2nd District, and the work rule exempts disabled expansion adults, though one the state does not identify as exempt must report hours. See the disability rights page.
• Addiction care: 13,006 Missouri Medicaid adults with opioid use disorder. KFF's 2021 count is 13,006 Missouri Medicaid adults with an opioid use disorder diagnosis, 7,451 on medication; treatment stops when coverage does. The mental health and addiction page explains the exemption.
• Child tax credit: 25,000 children in Wagner's district get less than the full amount. Columbia's district table finds 16% of the 2nd District's children, about 25,000, left below the full credit by the earnings phase-in. Child care and families page: more detail.
• Social Security: a $490 monthly cut for the average Missouri beneficiary arrives a quarter sooner. The law raises program costs by $168.6 billion and moves the retirement fund's exhaustion three months up; then CRFB projects Missouri's average benefit dropping $490 a month. See the Social Security page.
• Student loans: an extra $1,758 a year for Missourians pushed off SAVE. That is CAP's average for a Missouri borrower shifted onto the Repayment Assistance Plan. The student debt page has the votes.
• Veterans: SNAP's veterans exemption from the time limit is gone, with 21,000 Missouri veterans in SNAP homes. CBPP puts the number of Missouri veterans in SNAP households at 21,000, and the law took away veterans' exemption from the three-month limit. More on the veterans page.
• Taxes and debt: $13,600 a year for the top tenth, $1,200 lost by the bottom tenth, $4.2 trillion borrowed. CBO's distribution shows roughly $13,600 a year more for the top tenth of households and $1,200 less for the bottom tenth, and with interest the law adds $4.2 trillion to the debt through 2034. The taxes and deficit page has the rest.
• Energy bills: the average Missouri household could pay $640 a year more by 2035. Repealing clean-energy tax credits could push the average Missouri household's energy costs up about $640 a year by 2035, according to Energy Innovation projections reported by CNBC.

Frequently Asked Questions About Ann Wagner on One Big Beautiful Bill

Last updated: 2026-10-27

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