Republican David Rouzer, sworn in on January 3, 2015, has represented North Carolina's 7th District in the House ever since; his next election is November 3, 2026. The One Big Beautiful Bill Act, which will cost North Carolina $22.5 billion in federal Medicaid funding over ten years by KFF's estimate, got through the House by a single vote on May 22, 2025 with his aye, and on July 3, 2025 his aye went to the final law as well.
About David Rouzer
- Full name
- David Rouzer (Republican), as shown on his House Clerk member profile
- Current role
- Representative in Congress for North Carolina's 7th District
- In office since
- Rouzer took office January 3, 2015 and has held North Carolina's 7th District seat since
- Seeking
- A further House term in North Carolina's 7th District (general election: November 3, 2026)
- Key votes
- House passage of H.R. 1 (May 22, 2025, decisive); budget resolution H.Con.Res. 14 (February 25, 2025, decisive); final passage of H.R. 1 (July 3, 2025); H.Res. 1156, which hailed the law's tax provisions (April 16, 2026)
What David Rouzer Is Responsible For
- Medicaid funding. A $22.5 billion, ten-year hole in North Carolina's federal Medicaid money, KFF's estimate, is the headline cost of a law that cleared the House 215 to 214 on May 22, 2025 only with Rouzer's aye and that he voted for again on July 3. His district had 253,600 Medicaid enrollees in 2025, and the expansion's work requirement must be running "no later than January 1, 2027."
- Losing coverage. By 2034, the Congressional Budget Office expects 10 million more uninsured Americans because of the law Rouzer voted for, and KFF's state breakdown counts 300,000 of them in North Carolina.
- Hospitals. Both 2025 budget-resolution votes turned on Rouzer. The final law he voted for limits hospital payments, putting roughly $3.44 billion a year of federal payments for North Carolina hospital care above the new caps, KFF finds; the state's HASP payments, about $32 billion in federal support over a decade, disappear, per the North Carolina Medical Journal, and rural North Carolina loses $6.37 billion in Medicaid funds over ten years.
- SNAP. SNAP shrinks by $187 billion through 2034, about one-fifth, under the law Rouzer voted for, CBPP calculates. North Carolina's counties must find about $52 million for first-year administrative costs, and the state's benefit share comes to about $140 million in fiscal 2028.
- Medicare. Rouzer voted for what KFF calls the first law ever to take Medicare from people legally entitled to it, with coverage for lawfully present immigrants already identified ending February 1, 2027 under CMS's proposed timeline, and the hospital trust fund that serves North Carolina's 2,228,458 Medicare enrollees now runs short a quarter sooner, in 2033.
- Nursing-home care. Rouzer's July 2025 vote went to a law that puts the 2024 nursing-home staffing standard on hold until September 30, 2034 and also cuts the Medicaid funding that is the main payer for six in ten of North Carolina's 35,329 nursing-facility residents.
- Retirement benefits. The law Rouzer voted for costs Social Security a net $168.6 billion through 2034, the chief actuary estimates, and when the retirement fund runs out an across-the-board cut would take $501 a month from the average North Carolina beneficiary; 163,186 retired workers in the 7th District drew benefits in December 2024.
- Child tax credit. Some 56,000 children in North Carolina's 7th District, 37%, have parents whose earnings are too low for the full credit as written in the law Rouzer voted for, by the Columbia poverty center's count.
- Student loans. The Repayment Assistance Plan came out of the House bill Rouzer's May 2025 aye decided, and switching to it from SAVE costs a North Carolina borrower $1,767 more each year, CAP estimates; the enacted law also closed Graduate PLUS to new borrowers.
- Who the tax cuts help. Households in the top tenth gain about $13,600 a year and the lowest earners lose about $1,200 under the law Rouzer voted for, according to Congressional Budget Office estimates reported by Thomson Reuters, yet in April 2026 he voted for a resolution labeling it the "Working Families Tax Cuts."
- Energy costs. By 2035, a North Carolina household could pay about $490 a year more for energy because the law Rouzer voted for repealed clean-energy credits, an Energy Innovation projection found; Rhodium Group's projected 2035 emissions cut for the U.S. fell to 27 to 44 percent below 2005 levels, from 38 to 56 percent before the law.
- Lost jobs. Energy Innovation projects that the law's energy provisions, which Rouzer voted for in July 2025, mean "760,000 lost jobs by 2030."
- Planned Parenthood. A year without federal Medicaid payments, imposed by the law Rouzer voted for, left Planned Parenthood reporting close to 30 health-center closures in that span and Medicaid visits dropped 25%, more than 250,000 visits.
- ICE money. In the American Immigration Council's words, the law Rouzer voted for "directs $170.7 billion toward immigration and border enforcement," and NPR reported in March 2026 that "nearly 70,000 people are in ICE detention, the highest number in several years."
- Consumer protection. The Consumer Financial Protection Bureau's funding cap falls from 12% to 6.5% of a Federal Reserve benchmark with Rouzer's vote, which the Congressional Research Service puts at roughly $446 million for fiscal 2025 compared with $823 million, leaving less to police lenders and debt collectors.
- Silencers. Once the law Rouzer voted for ended the $200 federal levy on silencers and on short-barrel long guns, a federal judge held that registering them had lost its constitutional basis, and the ATF stopped requiring registration of those items on October 9, 2026.
How This Page on David Rouzer Is Sourced
Every vote here links to its Clerk of the House roll call, such as the May 22, 2025 House passage of H.R. 1, and every North Carolina or 7th District figure links to where it comes from, such as KFF's state Medicaid estimates or the Social Security Administration's district statistics; national figures link to KFF, CBPP, CRFB and other named sources. The page was last updated October 27, 2026, and each tally on it matches the Clerk's roll-call pages.
Frequently Asked Questions About David Rouzer
What is David Rouzer's record under Trump?
David Rouzer's record under Trump includes the One Big Beautiful Bill Act, which his ayes carried through both 2025 budget-resolution votes and the one-vote House passage before he voted for the final law. By KFF's estimate, North Carolina's federal Medicaid funding drops $22.5 billion over the decade because of it. Then, in April 2026, he joined a House vote hailing its tax provisions.
Did the House need David Rouzer's aye to pass the Big Beautiful Bill?
Yes, in May 2025: David Rouzer joined the 215 ayes that beat 214 nays on May 22, 2025, one member voting present, so the House version needed him. On July 3, 2025, the final version won 218 to 214 with his aye.
How big a Medicaid cut does North Carolina take from David Rouzer's vote?
North Carolina loses $22.5 billion under the law David Rouzer voted for, by KFF's split of the Congressional Budget Office estimate: that much in federal Medicaid funding over a decade, equal to 11% of what Washington would otherwise send, $6.37 billion of it from rural areas. Because the state's 2023 expansion law ends expansion coverage if its share "cannot be fully funded through the sources described in subsection (b)," the Carolina Journal noted, the hospital-tax limits also put the expansion at risk.
What does David Rouzer's vote cost households in southeastern North Carolina?
For North Carolina's 7th District, the district David Rouzer represents, the law he voted for touches 253,600 Medicaid enrollees and 214,870 Social Security beneficiaries, while 56,000 children there get only part of the child tax credit. Across North Carolina, a borrower leaving SAVE pays $1,767 more a year, and a household's energy costs could rise about $490 a year by 2035.
Did David Rouzer vote to cut SNAP?
Yes. David Rouzer's decisive February 2025 aye adopted the budget resolution that set a target of at least $230 billion for SNAP's committee, and the July 3, 2025 law he then voted for cuts SNAP $187 billion through 2034. North Carolina's SNAP participation has since dropped by more than 110,000 people.
What did the 2026 resolution David Rouzer voted for claim about the law?
David Rouzer's aye on H.Res. 1156 came on April 16, 2026, in a 219-to-207 vote; that text calls the law the "Working Families Tax Cuts" and claims a 15 percent cut for the bottom 40 percent, but ITEP found the poorest fifth of Americans pay a slightly higher average tax under it in 2026.
Last updated: 2026-10-27