Anna Paulina Luna's July 3, 2025 yea on the final One Big Beautiful Bill Act adds $8.8 billion to Medicare's drug spending by exempting more orphan drugs from price negotiation, and the law is the first ever to strip Medicare from people who had lawfully qualified, refugees and asylum grantees among them.
Earlier, Luna's decisive May 22, 2025 yea passed a House bill that would have paused two Medicaid enrollment rules, one of them easing enrollment in the Medicare Savings Programs that help with premiums, and the final law kept that pause. Her decisive April 2025 budget yea allowed the tax changes whose final version, by the trustees' 2026 math, drains Medicare's hospital fund a quarter sooner, in 2033. In Florida, 5,133,537 people had Medicare in 2024, by KFF's count.
Anna Paulina Luna's Votes on Medicare Coverage, Premiums and the Hospital Fund
- Medicare Owes $8.8 Billion More for Orphan Drugs and Cuts Off Some Enrollees Under the July 3, 2025 Law Luna Voted For. When the final version of H.R. 1 passed the House 218 to 214 on July 3, 2025, Anna Paulina Luna was a yea. The law's section 71201 removes Medicare eligibility for lawfully present immigrants lacking green cards, refugees and asylees included. In KFF's words, "This is the first time that Congress has eliminated Medicare coverage" for people who had been eligible; the Congressional Budget Office foresees "0.1 million Medicare beneficiaries losing their Medicare coverage as of 2034," and enrollees flagged during the grace period are cut off February 1, 2027, per the Center for Medicare Advocacy's account of CMS's proposed timeline. Separately, a wider orphan-drug carve-out from Medicare price negotiation runs Medicare an extra $8.8 billion, the Congressional Budget Office says.
- Luna Voted in May and July 2025 to Pause Two Enrollment Rules, One for the Programs That Pay Seniors' Medicare Premiums. Anna Paulina Luna's yea on May 22, 2025 was one of 215 that carried the House draft of H.R. 1 past 214 nays, a margin with no room to spare, and she voted for the final law on July 3. The House draft carried, and the final law kept, a pause on most of two rules, one aimed at sign-ups for the Medicare Savings Programs that cover Medicare premiums and one smoothing Medicaid enrollment, particularly for older adults and people with disabilities. An earlier Congressional Budget Office analysis, before the Senate's changes, found the delay would mean 1.3 million fewer people on Medicare also having Medicaid in 2034; KFF notes the enacted version's count could come in smaller, and CBO puts the law's savings from the pause at $122 billion. A low-income senior cut off from that help, KFF calculates, can wind up "paying $185 per month in Medicare premiums, or about 20% of income."
- Luna Voted for the Budget Plan and the Law Whose Tax Changes Pull the Medicare Hospital Fund's Depletion Forward One Quarter, Within 2033. On April 10, 2025, the House concurred 216 to 214 in the Senate's version of the H.Con.Res. 14 budget blueprint, and Anna Paulina Luna voted yea; her flip would have forced a 215-215 tie and killed it. The blueprint let Ways and Means draft tax cuts that "increase the deficit by not more than $4,500,000,000,000". Her July 3, 2025 yea went to a final law that trims the income tax on Social Security benefits, revenue that partly finances Medicare hospital insurance. The 2026 trustees now date that trust fund's depletion a quarter earlier than before, within 2033, primarily because the revenue is "lower than previously projected due to changes in the 2025 budget reconciliation bill," KFF reports.
What Anna Paulina Luna's Medicare Votes Cost Florida Seniors and the 13th District
- 21,200 seniors in Luna's district are on Medicaid, which pays Medicare premiums for low-income enrollees. KFF's district data count 21,200 seniors on Medicaid in Florida's 13th District in 2025. For a low-income senior, Medicaid can be what pays the Medicare premium and the copays, so pausing the rules that ease enrollment in that help means more eligible people in the district covering those costs from their own checks.
- Florida's 5.1 million Medicare beneficiaries depend on a hospital insurance fund whose depletion came one quarter sooner, in 2033. Florida's Medicare population was 5,133,537 in 2024, KFF reports: 2,249,967 in traditional Medicare and the rest in Medicare Advantage and other health plans. Each of them is covered by the hospital insurance fund now projected to come up short in 2033, a quarter earlier than before, and by a program carrying an extra $8.8 billion in orphan-drug costs.
Frequently Asked Questions About Anna Paulina Luna on Medicare
What is Anna Paulina Luna's record on Medicare under Trump?
Anna Paulina Luna voted yea on July 3, 2025 for the law that, for the first time, took Medicare away from people who had lawfully enrolled, kept a pause on two Medicaid enrollment rules (one covering the Medicare Savings Programs), and cut taxes in ways the trustees say move the Medicare hospital fund's depletion a quarter earlier, within 2033. Her decisive May 22 yea passed the House draft that first carried the pause, and her decisive budget yea in April 2025 allowed the deficit-financed tax changes.
What does the orphan-drug change Anna Paulina Luna voted for cost Medicare?
Anna Paulina Luna's July 3, 2025 yea covered section 71203 of the law, which exempts more rare-disease drugs from Medicare's price talks; the Congressional Budget Office pegs the cost to Medicare at $8.8 billion. KFF expects negotiation on the cancer drugs Keytruda and Opdivo to be pushed back "by at least one year"; in 2023, "Medicare and beneficiaries spent $5.6 billion on Keytruda and $2.0 billion on Opdivo." Florida's 5,133,537 Medicare enrollees are part of the program paying that bill.
Which Floridians lose Medicare because of Anna Paulina Luna's vote?
The law Anna Paulina Luna voted for ends Medicare eligibility for lawfully present immigrants who hold no green card, so refugees and people granted asylum in Florida lose access. Under CMS's proposed timeline, anyone already enrolled and flagged during the grace period is dropped on February 1, 2027, according to the Center for Medicare Advocacy.
Last updated: 2026-10-27