On July 3, 2025, Bryan Steil, the House member for Wisconsin's 1st District, voted for final passage of the One Big Beautiful Bill Act, whose Medicaid cuts reach millions of people over 50 on Medicaid, by KFF's count; his May vote for the House version was decisive. The law blocks the federal nursing-home staffing rule through September 2034 and limits the state taxes and payments that help pay nursing homes.
Steil also cast a deciding vote for the budget plan that told the committee over Medicaid to cut at least $880 billion. Medicaid is the main source of payment for 55% of Wisconsin's nursing-home residents.
Bryan Steil's Votes on Nursing Homes, Home Care and Older Adults
- Steil Voted for Medicaid Cuts That Reach Older Wisconsinites and a Block on the Nursing-Home Staffing Standard, in July 2025. On July 3, 2025, Bryan Steil 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 under the Medicaid program." The law bars federal enforcement of the 2024 nursing-home staffing rule until September 30, 2034, which KFF says locks in a federal judge's ruling against key parts of the rule. KFF reports that blocking the rule cuts federal Medicaid spending by $23 billion over ten years; the Consumer Voice, an advocacy group for residents, says "The minimum staffing rule was estimated to save 13,000 lives annually." The law's limits on provider taxes and state-directed payments, which help pay nursing homes, account for $340 billion in federal cuts over ten years.
- Steil Cast a Deciding Vote for the House Bill, Including Cuts to Help for Low-Income Seniors, in May 2025. On May 22, 2025, Steil voted for the House version of H.R. 1, which passed 215 to 214, so it could not have passed without his vote. Like the final law, it put a moratorium on most of two rules that help low-income seniors enroll in the programs that pay their Medicare premiums and cost sharing. Halting those rules is "collectively estimated to reduce federal Medicaid spending by $122 billion," KFF reports, and a senior who loses that help could end up paying $185 a month in Medicare premiums, about a fifth of income.
- Steil Cast a Deciding Vote for the Budget Plan That Told the Committee Over Medicaid to Cut $880 Billion, in February 2025. On February 25, 2025, Steil voted for H.Con.Res. 14, the budget resolution, which passed 217 to 215; a switch by him 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". KFF reports that "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 says the optional nature of home care makes it "more vulnerable to reductions during periods of state or federal budget constraints."
What the Medicaid Cuts Bryan Steil Voted For Mean for Wisconsin Nursing Homes and Home Care
- Medicaid pays for most Wisconsin nursing-home residents. Medicaid is the primary payer for 55% of residents in Wisconsin's certified nursing facilities, which housed 17,668 people in 2025, according to KFF, and KFF says the law's limits on provider taxes and payments could reduce federal funds for nursing facilities, which pay for those residents' care and staff.
- 15,000 seniors and 19,900 people with disabilities in Steil's district rely on Medicaid. KFF counts 15,000 seniors and 19,900 people with disabilities among the Medicaid enrollees in Wisconsin's 1st District in 2025; KFF warns the law's cuts risk "reducing access to health and long-term care services for people who remain enrolled in the program."
Frequently Asked Questions About Bryan Steil on Elder care
What is Bryan Steil's record on elder care under Trump?
Bryan Steil cast deciding votes for the One Big Beautiful Bill Act's House version and its budget plan and voted for the final law, which bars the nursing-home staffing standard until 2034 and cuts the Medicaid money that pays for most nursing-home and home care. In Wisconsin, a majority of nursing-home residents rely on Medicaid as their primary payer.
Will the law Bryan Steil voted for cut home care for seniors in Wisconsin?
Bryan Steil voted for a law that cuts federal Medicaid funding to Wisconsin by $6.745 billion over ten years, by KFF's estimate, and most Medicaid home care is optional for states, which leaves it exposed when those dollars shrink. KFF found that "44 out of the 50 responding states constrain spending" on home care already.
What happened to the nursing-home staffing rule after Bryan Steil's vote?
The law Bryan Steil voted for on July 3, 2025 barred the 2024 staffing rule until 2034, and on December 2, 2025 the administration issued an interim final rule that repealed the minimum staffing standards for nursing homes, LeadingAge reported.
Last updated: 2026-10-26