On July 3, 2025, Ashley Hinson voted for final passage of the One Big Beautiful Bill Act, whose Medicaid cuts KFF says could affect the 22 million people ages 50 and older on Medicaid. The law bars the nursing-home staffing standard until 2034 and limits the state taxes that help pay nursing homes.
In April 2025, Hinson had said "we don’t want to cut benefits to people". Medicaid is the main payer for nursing-home care in Iowa.
Ashley Hinson's Votes and Statements on Nursing Homes, Home Care and Older Adults
- Hinson Voted for Medicaid Cuts That Reach Older Iowans and an End to the Nursing-Home Staffing Standard, in July 2025. On July 3, 2025, Ashley Hinson voted for final passage of H.R. 1, the One Big Beautiful Bill Act, which passed 218 to 214. KFF says its Medicaid cuts could affect the 22 million people ages 50 and older with coverage through Medicaid. The law bars federal enforcement of the 2024 nursing-home staffing rule ending September 30, 2034, which KFF says will reduce federal Medicaid spending by $23 billion over 10 years; the Consumer Voice, an advocacy group for residents, says the minimum staffing rule was estimated to save 13,000 lives annually. Its limits on provider taxes and state-directed payments, which help pay nursing homes, account for $340 billion over ten years.
- Hinson Cast One of the Votes That Passed the House Bill by a Single Vote, Including Work Rules for Older Adults, in May 2025. On May 22, 2025, Hinson voted for the House version of H.R. 1, which passed 215 to 214, so it could not have passed without her vote. The law requires adults in the Medicaid expansion up to age 64 to report work or an exemption, and KFF found that fewer than half of adults ages 50-64 would meet the work requirements through either employment or school, so older adults caring for family members or in poor health must document an exemption to keep coverage.
- Hinson Voted for the Budget Plan That Ordered the Medicaid Cut, by Two Votes, in February 2025. On February 25, 2025, Hinson voted for H.Con.Res. 14, the budget resolution, which passed 217 to 215; a switch by her alone would have tied it, and a tie fails. It told the Energy and Commerce Committee to reduce the deficit by not less than $880,000,000,000. Medicaid pays for almost 70% of all home care spending in the U.S., nearly all of which is provided through optional services, and the Bipartisan Policy Center reports experts expect the law will slow or reverse recent HCBS expansion efforts in states.
- Hinson Said Republicans Did Not Want to Cut Benefits, Weeks Before Voting for the Medicaid Cuts, in April 2025. At an April 2, 2025 tele-town hall, asked about Medicaid, Hinson said: "Republicans have been clear, we don’t want to cut benefits to people. We want to strengthen these programs for current and future beneficiaries." The law she voted for reduces federal Medicaid spending by an estimated $911 billion over ten years, and it makes it harder for low-income seniors to get help with Medicare premiums through rules collectively estimated to reduce federal Medicaid spending by $122 billion.
What the Medicaid Cuts Ashley Hinson Voted For Mean for Iowa's Nursing Homes and Home Care
- Home care waiting list. 28,778 Iowans were already waiting for Medicaid home care in 2026, and Iowa does not screen them for eligibility. Caring Across Generations, an advocacy group, reports that Iowa families have received unexplained notices of reduced care hours for loved ones.
- Nursing homes. Medicaid is the primary payer for 52% of Iowa nursing-home residents, according to KFF.
Frequently Asked Questions About Ashley Hinson on Elder care
What is Ashley Hinson's record on elder care under Trump?
Ashley Hinson voted for the One Big Beautiful Bill Act in May and July 2025, and her May vote was one of the 215 that passed the House version by one vote. The law bars the nursing-home staffing standard until 2034 and cuts the Medicaid money that pays for most nursing-home and home care. Medicaid pays for 52% of Iowa nursing-home residents.
Will the One Big Beautiful Bill Act cut home care for seniors in Iowa?
The law Ashley Hinson voted for cuts federal Medicaid by an estimated $911 billion over ten years, and most Medicaid home care is optional for states, which makes it more vulnerable to reductions during periods of state or federal budget constraints, the Bipartisan Policy Center says. KFF found that 44 out of the 50 responding states constrain spending on home care already.
What happened to the nursing-home staffing rule?
The law Ashley Hinson voted for on July 3, 2025 barred the 2024 staffing rule until 2034, and in December 2025 the administration released an interim final rule repealing the nursing home minimum staffing standards, which had required 3.48 hours per resident, per day of total nurse staffing.
Last updated: 2026-10-25