On July 3, 2025, Ashley Hinson of Iowa voted for final passage of the One Big Beautiful Bill Act, whose Medicaid work requirement applies to expansion Medicaid, the primary coverage pathway for people with mental health or substance use disorders. Earlier in 2025 she cast decisive votes for the budget plan that ordered the Medicaid cut (roll call 100).
In July 2026 Hinson defended the work requirement, saying "you should be working".
Ashley Hinson's Votes and Statements on Medicaid Coverage for Treatment
- Hinson Voted for Medicaid Work Requirements That Reach People in Addiction and Mental Health Treatment, in 2025. On July 3, 2025, Ashley Hinson voted for final passage of the One Big Beautiful Bill Act, after casting one of the votes that passed the House version 215 to 214 in May. Its work requirement applies to expansion Medicaid, which is the primary coverage pathway for people with mental health or substance use disorders, KFF found, and it exempts people with a substance use disorder; ``(cc) with a disabling mental disorder only if they prove it. States must verify eligibility again every six months thereafter, starting no later than December 31, 2026, and the exemption covers only “disabling” mental disorders. The Commonwealth Fund warned that many who lose coverage will remain eligible for Medicaid but who did not successfully complete the paperwork, and when Arkansas tried a work requirement, the result was over 18,000 people losing coverage.
- Hinson Voted for the Budget Plan That Ordered the Medicaid Cut, by Margins of Two Votes, in 2025. On February 25, 2025, Hinson voted for H.Con.Res. 14, the budget resolution, which passed 217 to 215, and on April 10, 2025 for the final version, which passed 216 to 214; on each vote a switch by her alone would have tied it, and a tie fails. It instructed the committee that oversees Medicaid to reduce the deficit by not less than $880,000,000,000. KFF warned that the law's cuts and a more tenuous fiscal climate for states may make those gains harder to sustain, meaning states' recent expansions of mental health and addiction treatment in Medicaid.
- Hinson Defended the Medicaid Work Requirements in July 2026. At the Plymouth County Fair on July 31, 2026, Hinson said, "If you’re going to take a taxpayer benefit, you should be working", KTIV reported. Medicaid covers nearly one in three (29%) adults with mental illness nationally, and Medicaid covers 47% of all nonelderly adults with OUD, KFF found.
- Hinson Said the Law Strengthens Medicaid; Many in Treatment Could Lose Coverage Over Paperwork. On July 3, 2025, Hinson said the One Big Beautiful Bill Act "strengthens Medicaid for vulnerable populations". KFF found that among Medicaid expansion enrollees specifically, 24% have a diagnosed behavioral health condition, the group whose coverage now depends on proving an exemption or reporting work every six months.
What the Medicaid Changes Ashley Hinson Voted For Mean for Iowans in Treatment
- Mental illness on Medicaid. Iowa has the highest share of adult Medicaid enrollees with a mental illness of any state, KFF found: the share ranges from 22% in New Jersey to 51% in Iowa.
- People exposed. 25,046 Iowans with a substance use disorder and 67,478 with a mental illness were enrolled in expansion Medicaid in 2021, and 69% of Iowa Medicaid adults with opioid use disorder were covered through expansion, KFF's data show. Iowa HHS says its Medicaid work requirements take effect December 1, 2026.
Frequently Asked Questions About Ashley Hinson on Mental health and addiction
What is Ashley Hinson's record on mental health and addiction under Trump?
Ashley Hinson of Iowa voted for the One Big Beautiful Bill Act and its budget plan, and the law's Medicaid work requirement covers expansion Medicaid, the primary coverage pathway for adults with mental health and substance use disorders. She has defended the requirement and said the law "strengthens Medicaid for vulnerable populations".
Are people with addiction exempt from the Medicaid work requirements Ashley Hinson supported?
People with addiction are exempt from the work requirements Ashley Hinson voted for only if they prove it, and states must check again every six months thereafter. The law's exemption for mental illness reaches only “disabling” mental disorders, so people whose mental illness is not judged disabling must report work hours or lose coverage.
How many Iowans in addiction treatment rely on expansion Medicaid?
In Iowa, 69% of Medicaid adults with opioid use disorder were covered through expansion Medicaid in 2021, the program whose rules Ashley Hinson voted to change, according to KFF. Medicaid pays for over half (56%) of those receiving medication for opioid use disorder nationally.
Last updated: 2026-10-25