The One Big Beautiful Bill Act saves federal money on Medicaid mostly by narrowing how states raise their own share of the program and by making working-age adults document work hours to stay enrolled, and KFF calculates that Wisconsin ends up with $6.745 billion less federal Medicaid funding over a decade. Derrick Van Orden of Wisconsin's 3rd District was the margin on May 22, 2025, when the House approved the bill by one vote, and he was a yes on July 3, 2025, when it cleared Congress.
Van Orden had already decided the spring 2025 budget resolution twice, in February and again in April, and that resolution is what told the Medicaid committee to come up with at least $880 billion. About one in five people in his district, 144,000 in all, were on Medicaid in 2025, and Wisconsin's health department expects about 63,000 BadgerCare members to be at risk of losing coverage once the law's work rule starts.
Derrick Van Orden's Votes for the Medicaid Cuts in the One Big Beautiful Bill Act
- $6.745 Billion in Medicaid Cuts Leave Wisconsin Under the Final Law That Got Van Orden's July 2025 Yes, Two Months After His One-Vote House Margin. When the House counted votes on H.R. 1 on May 22, 2025, the bill drew 215 yeas against 214 nays, with one present; Derrick Van Orden cast one of those 215 yeas, so the bill needed him. Six weeks later, on July 3, 2025, his yea helped carry the Senate-amended bill, 218 to 214. Congressional Budget Office figures, as KFF reports them, put the national Medicaid reduction at $911 billion across ten years, with the rise in the uninsured at 10 million people by 2034. Split by state, KFF assigns $6.745 billion of that reduction to Wisconsin, 8% of what federal Medicaid would otherwise have sent.
- Provider-Tax and Hospital-Payment Caps Shrink Medicaid Funding; They Arrived in the July 2025 Law Van Orden Voted For, Months After His Deciding Budget Votes Set the $880 Billion Instruction. On H.Con.Res. 14, Van Orden's yes on February 25, 2025 (217 to 215) and his yes on the Senate's rewrite on April 10, 2025 (216 to 214) were each decisive: one switch by him produces a tie, and a tied resolution fails. The text directed Energy and Commerce, the House committee that writes Medicaid law, to "reduce the deficit by not less than $880,000,000,000". He then voted for H.Res. 436, the May 22 rule that opened floor debate on H.R. 1, and on July 3, 2025 his yea went to the final law carrying the financing caps (218 to 214). Two financing limits in the final law account for much of the Medicaid cut that followed. One caps the provider taxes a state can lean on to fund its Medicaid match, which the budget office prices at $191 billion in lost federal money over ten years. The other lowers the ceiling on state-directed payments, and KFF expects that "payment rates for hospital services will decrease in at least 37 states" beginning in 2028. In Wisconsin, roughly $969 million a year of federal hospital spending is above that ceiling, KFF estimates.
How the Medicaid Cuts Derrick Van Orden Voted For Reach Wisconsin's 3rd District
- Nearly one resident in five in Wisconsin's 3rd District depends on the Medicaid program the law shrinks. Medicaid enrollment in Wisconsin's 3rd District reached 144,000 in 2025, or 19% of residents, under KFF's district data, with children (47,300) the largest group after adults (59,100), followed by seniors (20,100) and people with disabilities (17,500). All of them are covered with federal dollars the law cuts for Wisconsin.
- The work rule leaves about 63,000 BadgerCare members in danger of being dropped. Because Wisconsin covers its low-income adults through BadgerCare rather than the ACA expansion, the law's work rule falls on BadgerCare Plus adults ages 19 to 64 with no children under 19 at home. The state health department counts about 200,000 such adults among roughly 800,000 BadgerCare Plus members and estimates some 63,000 could be dropped. Enforcement begins on January 1, 2027.
- The law alone leaves 76,000 more Wisconsinites without insurance by 2034. KFF's projection credits the law itself with 76,000 more uninsured people in Wisconsin in 2034, somewhere between 57,000 and 95,000, about one percentage point on the state's uninsured rate.
- Rural Wisconsin's share of the law's Medicaid cut comes to $1.7 billion across a decade. KFF estimates that $1.7 billion of the law's federal Medicaid reduction over ten years falls on rural Wisconsin, money that would otherwise pay for the care of rural residents enrolled in Medicaid.
Frequently Asked Questions About Derrick Van Orden on Health Care
What is Derrick Van Orden's record on health care under Trump?
Derrick Van Orden's vote was one the House could not spare when it first passed H.R. 1 on May 22, 2025, and he voted for the finished law on July 3, 2025. Its Medicaid reduction comes to $911 billion nationally over ten years by the budget office's count, with $6.745 billion of it falling on Wisconsin, KFF calculates. Earlier, his February and April 2025 votes each decided the budget resolution that gave the committee writing Medicaid law an $880 billion savings instruction.
What would the work rule Derrick Van Orden voted for ask of a BadgerCare patient in western Wisconsin?
In the law Derrick Van Orden voted for, a BadgerCare Plus adult with no children under 19 at home qualifies each month through 80 hours of a job, volunteering, job training or half-time classes, or with at least $580 in monthly income, unless an exemption such as medical frailty or caring for a child under 14 applies. Wisconsin starts checking new applicants on January 1, 2027, looking at the month before they apply, and most current members meet it at renewals due from March 31, 2027.
How do the hospital payment caps in Derrick Van Orden's votes affect hospitals in western Wisconsin?
Derrick Van Orden's July 3, 2025 yes went to the law that holds the limit on state-directed payments, the extra Medicaid money a state channels to hospitals and other providers. KFF puts Wisconsin's federal spending through those payments at about $1.79 billion a year, $1.37 billion of it on hospital services, and the hospital portion over the new limit is what gets ratcheted down starting in 2028.
Last updated: 2026-10-27