Adults with certain disabilities and serious medical conditions sit outside the One Big Beautiful Bill Act's Medicaid hours requirement, yet a covered disabled adult whose exemption the state's records do not show has to document it or report 80 hours a month; Derrick Van Orden, Wisconsin's 3rd District member, voted for the law on July 3, 2025, after his vote decided the House version, and federal Medicaid officials project the rule will shrink enrollment by 2.3 million people in fiscal 2027.
Van Orden's deciding February and April 2025 budget votes put an $880 billion savings demand on the Medicaid committee, and home and community-based services, the help that lets many disabled people live outside institutions, are mostly optional for states and so among the benefits analysts call more vulnerable to cuts. Medicaid covered 17,500 people with disabilities in his district in 2025, and 9,160 Wisconsinites sit on the waiting list for Medicaid home care.
Derrick Van Orden's Votes on Medicaid Rules for People With Disabilities
- A Work Rule That Can Drop Disabled Adults Over Missing Exemption Paperwork Puts Their Medicaid at Risk, Enacted With Van Orden's 2025 Votes. Derrick Van Orden's yea on July 3, 2025 counted toward the 218-to-214 tally that sent the final version to the president, and two months earlier his yea had been essential to the House version's 215-to-214 win. Covered adults must log 80 hours of work or other qualifying activity each month. Exempt groups on the law's list include blind and disabled individuals, those whose mental disorder is disabling, anyone carrying a serious or complex medical condition, and someone "with a physical, intellectual or developmental disability that significantly impairs their ability to perform 1 or more activities of daily living"; states are told to confirm exemptions from information they already hold where possible, and a disabled adult those records miss must document the exemption. In the rule it issued to carry out the requirement, the Centers for Medicare and Medicaid Services estimates that "enrollment would be reduced by 2.3 million individuals in FY 2027."
- An $880 Billion Savings Target for the Medicaid Committee Squeezes Optional Home and Community Services, Set by Van Orden's Deciding Budget Votes in 2025. Van Orden voted for H.Con.Res. 14 when it passed 217 to 215 on February 25, 2025, and again when the House took the Senate's version 216 to 214 on April 10, 2025; either time, his switch would have forced a tie, which a resolution cannot survive. The resolution told the committee that writes Medicaid law to "reduce the deficit by not less than $880,000,000,000" over ten years. Home and community-based services, the in-home and community help that keeps many disabled people out of institutions, are "largely an optional Medicaid benefit," the Bipartisan Policy Center notes, and the experts it cites expect the law to "slow or reverse recent HCBS expansion efforts" across states.
What Derrick Van Orden's Votes Mean for Wisconsinites With Disabilities
- Medicaid is the coverage of 17,500 disabled residents of Wisconsin's 3rd District, and the law cuts it. Wisconsin's 3rd District had 17,500 Medicaid enrollees with disabilities in 2025, about one in eight of its 144,000 enrollees, KFF's district count shows. A disabled adult whose coverage runs through BadgerCare Plus, rather than another Medicaid program, falls under the work rule unless an exemption applies, such as being medically frail or having special medical needs.
- 9,160 Wisconsinites already wait for Medicaid home care the budget target puts under pressure. KFF lists 9,160 people on Wisconsin's waiting list for Medicaid home and community-based waiver services. Each name on that list is someone who qualifies for in-home help but has not yet received it, and a tighter Medicaid budget makes room for fewer of them.
- About 200,000 BadgerCare adults must clear the work rule or an exemption, and 63,000 are at risk. Wisconsin's health department counts about 200,000 BadgerCare Plus adults subject to the requirement, among them disabled adults who have not been classified as exempt, and it estimates some 63,000 members could lose coverage once it starts on January 1, 2027.
Frequently Asked Questions About Derrick Van Orden on Disability rights
What is Derrick Van Orden's record on disability rights under Trump?
Derrick Van Orden's July 3, 2025 vote went to a law whose work rule can cut off a disabled Medicaid adult whose exemption is missing from state records, and his May 2025 vote decided the House version. Federal Medicaid officials project the rule will reduce enrollment by 2.3 million in fiscal 2027. His deciding 2025 budget votes set the $880 billion savings goal handed to the committee that writes Medicaid law, which leaves optional home and community services squeezed.
How does a BadgerCare adult with a disability in western Wisconsin get out of the work rule Derrick Van Orden voted for?
Under the law Derrick Van Orden voted for, a Wisconsin adult in BadgerCare Plus who has a disability is excused if the person counts as medically frail or having special medical needs, a group that includes people who are blind or disabled, have a disabling mental disorder or have a serious or complex medical condition; other exemptions, such as caring for a disabled person or taking part in a treatment program, can also apply, and otherwise the 80-hour monthly requirement does. Adults whose Medicaid comes through other Wisconsin programs, including home and community-based services and Katie Beckett Medicaid, are outside the rule, the state health department says.
Can a disabled adult in western Wisconsin lose Medicaid over paperwork under the law Derrick Van Orden voted for?
Yes: the law Derrick Van Orden voted for on July 3, 2025 lets states confirm exemptions from data they already hold, but a disabled adult the state's data miss must document the exemption, and missed paperwork can end coverage. The Commonwealth Fund warned that many people who lose coverage under work rules "will remain eligible for Medicaid but who did not successfully complete the paperwork."
Last updated: 2026-10-27