Limits on provider taxes and state-directed payments, two streams of money that help pay hospitals and keep nursing homes running, remove $340 billion in federal Medicaid funding over ten years under the One Big Beautiful Bill Act, which Eli Crane, Arizona's 2nd District congressman, voted for on July 3, 2025; the same law keeps the federal nursing-home staffing standard unenforced until September 30, 2034.
Crane's votes for the House bill in May and the budget resolution in February were each needed for passage. Back in Arizona, 54% of the state's 11,931 nursing-facility residents counted on Medicaid as their first payer in 2025.
Eli Crane's Votes on Nursing Homes, Home Care and Help for Low-Income Seniors
- $340 Billion Cut From the Financing That Helps Pay Hospitals and Nursing Homes, and a Staffing Standard Blocked Until 2034: Crane's July 2025 Vote. Eli Crane was among the yeas when H.R. 1 cleared the House for the last time, 218 to 214, on July 3, 2025. KFF cautions that its Medicaid cuts "could affect the 22 million people ages 50 and older with coverage under the Medicaid program." Washington may not enforce the 2024 staffing rule for nursing homes through September 30, 2034, a ban KFF says locks a court loss into place for the rule's core. Keeping the rule on the shelf saves the federal government $23 billion in Medicaid outlays over ten years, by KFF's account; Consumer Voice, a residents' advocacy group, says "The minimum staffing rule was estimated to save 13,000 lives annually." The provider-tax and state-directed-payment limits, used to pay nursing homes as well as hospitals and other providers, add up to $340 billion in federal reductions across ten years.
- A Freeze on Two Medicaid Enrollment Rules, Scored at $167 Billion in the House Bill, Rode on Crane's Deciding May 2025 Vote. The May 22, 2025 House bill needed Crane's yes to squeak through 215 to 214. Just as the final law does, it put on hold most of two rules written to make signing up for and keeping Medicaid easier, including for seniors with little income whose Medicare premiums and cost sharing Medicaid helps cover. CBO's estimate of the savings from those holds was $167 billion before the Senate's changes and $122 billion for the law as enacted, KFF reports; KFF's example senior who loses the help pays $185 monthly for Medicare, close to 20% of income.
- Crane Cast the Deciding Vote in February 2025 for an $880 Billion Savings Target for Medicaid's Committee, Putting Home Care in Line for Cuts. When the House adopted H.Con.Res. 14 217 to 215 on February 25, 2025, Crane was in the majority; had he alone switched, the resulting tie would have failed. Its directive to Energy and Commerce read: "reduce the deficit by not less than $880,000,000,000". Home care is where that pressure lands: "Medicaid pays for almost 70% of all home care spending in the U.S., nearly all of which is provided through optional services," KFF notes, and in the Bipartisan Policy Center's view that makes home care "more vulnerable to reductions during periods of state or federal budget constraints."
What Eli Crane's Votes Cost Older Arizonans in Nursing Homes, at Home and in the 2nd District
- Medicaid is the first payer for 54% of the 11,931 Arizonans living in nursing homes. KFF data count 11,931 residents of certified nursing facilities across Arizona in 2025, and for 54% of them Medicaid is the primary payer. For most Arizona nursing-home residents, then, the bed, the meals and the aides are paid for by the program whose financing the law squeezes.
- Crane's district has 26,500 seniors and 19,900 disabled residents on the Medicaid rolls. KFF's 2025 figures for Arizona's 2nd District show 26,500 seniors and 19,900 disabled people enrolled in Medicaid; for many it is what pays for a nursing-home stay or an aide at home, and the state's federal Medicaid money drops by $34.47 billion in the decade ahead.
- Arizona nursing-home residents lost the 2024 federal staffing floor. Arizona residents of nursing homes lose the 2024 rule's federal minimum staffing standards, whose enforcement is barred until 2034, and on December 2, 2025 the administration repealed those standards outright with an interim final rule, LeadingAge reported.
Frequently Asked Questions About Eli Crane on Elder care
What is Eli Crane's record on elder care under Trump?
On elder care, Eli Crane cast deciding votes for the February 2025 budget plan and the May House bill, then voted for the July final law. The law leaves the 2024 federal staffing floor for nursing homes unenforced until 2034 and tightens the Medicaid financing that covers more than half of Arizona's nursing-home residents before any other payer.
What do the Medicaid cuts Eli Crane voted for cost Arizona nursing homes?
KFF's estimate is that the law Eli Crane voted for leaves Arizona $34.47 billion short in federal Medicaid dollars through 2034, and 54% of Arizona's nursing-home residents have Medicaid paying first. Across the country, the law's curbs on provider taxes and state-directed payments, which help finance hospitals and nursing homes, total $340 billion over a decade.
Could Eli Crane's vote shrink in-home care for older Arizonans?
Eli Crane's February 2025 budget vote and his vote for the final law put pressure on the part of Medicaid that pays for home care, which states treat as optional; KFF found that even before the law, "44 out of the 50 responding states constrain spending" on it. With $34.47 billion less in federal Medicaid money coming to Arizona over a decade, that optional care is "more vulnerable to reductions," as the Bipartisan Policy Center puts it.
Last updated: 2026-10-27