Derek Schmidt voted on July 3, 2025 for a One Big Beautiful Bill Act that removes $3.351 billion in federal funds from Kansas Medicaid over ten years, the program that in 2021 covered 1,998 Kansas adults diagnosed with opioid use disorder, and he had supplied a deciding vote for the House version in May.
His deciding votes for the 2025 budget resolution in February and April told the Energy and Commerce Committee to find at least $880 billion in deficit reduction. Across the country, Medicaid covers over half of everyone on medication for opioid addiction, and the law's work rules, which start by January 1, 2027 for expansion adults, exempt people with substance use disorders or disabling mental illness, an exemption states are to confirm from data they already hold.
Derek Schmidt's Votes on Medicaid Coverage for Mental Health and Addiction Care
- People in Addiction and Mental Health Treatment Face New Medicaid Paperwork Under the Work Rules Schmidt Voted For in July 2025. Derek Schmidt's May vote was one the House version needed to pass 215 to 214, and on July 3, 2025 he voted for the final law, which cleared 218 to 214. Starting by January 1, 2027, expansion adults with a substance use disorder, or "with a disabling mental disorder", are exempt from the 80-hour reporting rule, and states must "use available data to verify exemptions" for them. The rule applies to expansion Medicaid, which KFF describes as "the primary coverage pathway for people with mental health or substance use disorders". A person whose mental illness is not judged disabling, and who fits no other exemption, will have to document work hours, and when a state's data check falls short, people lose coverage: the Commonwealth Fund cautioned that many of those dropped "will remain eligible for Medicaid but who did not successfully complete the paperwork."
- States' Gains in Medicaid-Funded Treatment Are Harder to Sustain Under the July 2025 Law That Followed Schmidt's Deciding Budget Votes. Both House votes on the budget blueprint, H.Con.Res. 14, were close enough for Derek Schmidt to decide: it carried by two votes, 217 to 215, on February 25, 2025; the final text then cleared by the same two-vote margin, 216 to 214, on April 10, with his yes each time. It instructed the committee that writes Medicaid law to "reduce the deficit by not less than $880,000,000,000." KFF warned that with the law's cuts, "a more tenuous fiscal climate for states may make those gains harder to sustain," meaning the mental health and addiction services states have built up through Medicaid, which covers "over half (56%) of those receiving medication" for opioid use disorder nationwide.
What Derek Schmidt's Medicaid Votes Mean for Kansans in Treatment
- Fewer than half of Kansas Medicaid adults with opioid addiction got medication treatment, and the law cuts that money. KFF data show 1,998 adult Medicaid enrollees in Kansas were diagnosed with opioid use disorder in 2021, and only 939, fewer than half, got medication to treat it. Those prescriptions and counseling visits are paid out of the Medicaid budget the law shrinks by $3.351 billion in Kansas over the decade.
- 23,800 adults in Kansas's 2nd District depend on Medicaid for their care. In Kansas's 2nd District, 23,800 working-age adults were on Medicaid in 2025, along with 21,000 people with disabilities, by KFF's count. Medicaid is the payer behind much of the mental health and addiction care states have added in recent years, and KFF expects tighter state budgets under the law to make that care harder to keep.
Frequently Asked Questions About Derek Schmidt on Mental health and addiction
What is Derek Schmidt's record on mental health and addiction under Trump?
Derek Schmidt's votes decided the budget blueprint that told Medicaid's committee to find $880 billion or more and the One Big Beautiful Bill Act's narrow House win, and he voted for the law itself in July 2025. The law cuts federal Medicaid funding for Kansas by $3.351 billion over ten years and, from January 1, 2027, adds work rules for expansion adults that reach some people in mental health and addiction treatment. Only 939 Kansas Medicaid adults were getting medication for opioid addiction in 2021.
What happens to people in recovery under the Medicaid work rules Derek Schmidt voted for?
Derek Schmidt voted on July 3, 2025 for work rules that, starting by January 1, 2027, exempt expansion adults with a substance use disorder; states must check that exemption against data they already have, and people in recovery can still lose coverage when the check fails. When Arkansas tried a Medicaid work requirement, the result was "over 18,000 people losing coverage," KFF found.
Did Derek Schmidt's vote on the Medicaid bill decide whether it passed?
Yes. Derek Schmidt's yes on May 22, 2025 came on a bill that passed 215 to 214, so it would have failed without him, and his budget resolution votes, adopted 217 to 215 and 216 to 214, were each enough to change the result. The final law, which he also voted for, passed 218 to 214.
Last updated: 2026-10-27