The staffing standard for nursing homes cannot be enforced until September 30, 2034, under a law Greg Murphy voted for. He cast that vote on July 3, 2025. KFF counts 22 million people age 50 and up on Medicaid nationwide. The law's caps on provider taxes and on state-directed payments take $340 billion out of federal Medicaid spending, a reduction that reaches hospitals as well as nursing homes.
Murphy's yes was one of the 215 that passed the House bill on May 22, 2025. That bill paused two enrollment rules, one for Medicare premium aid and one for Medicaid, the second aimed above all at older and disabled people. His February 2025 budget vote also decided the outcome. Six in ten North Carolina nursing-home residents rely on Medicaid as their main payer.
Greg Murphy's Votes on Nursing Homes, Home Care and Help for Seniors
- Murphy Voted to Shelve the Nursing-Home Staffing Standard Until 2034. Greg Murphy voted yes when H.R. 1 cleared the House for good on July 3, 2025. The count was 218 to 214. The law bars enforcement of the 2024 staffing rule for nursing homes until September 30, 2034. KFF says the delay locks in a court decision against the rule's main parts. KFF also warns the law's Medicaid cuts "could affect the 22 million people ages 50 and older with coverage under the Medicaid program." Blocking the rule takes $23 billion out of federal Medicaid spending over ten years, KFF reports. The Consumer Voice, a residents' advocacy group, says "The minimum staffing rule was estimated to save 13,000 lives annually." Another $340 billion comes out through new caps on provider taxes and state-directed payments. Nursing homes draw on both.
- Murphy's Deciding Vote Froze Two Rules That Ease Seniors' Enrollment in Premium Aid and Medicaid. H.R. 1 first cleared the House 215 to 214 on May 22, 2025, and Murphy's yes was one it could not spare. Like the final law, it put most of two enrollment rules on hold. One makes it easier for low-income seniors to join programs that pay Medicare premiums and cost sharing. The other simplifies Medicaid enrollment, above all for older and disabled people. Under the final law, pausing them is "collectively estimated to reduce federal Medicaid spending by $122 billion," KFF reports.
- Murphy's Deciding Budget Vote Put Medicaid Home Care on the Chopping Block. On February 25, 2025, H.Con.Res. 14 was adopted 217 to 215 with Murphy's vote. His switch would have tied it, and a tie loses. The resolution directed the Energy and Commerce Committee to "reduce the deficit by not less than $880,000,000,000". KFF reports that "Medicaid pays for almost 70% of all home care spending in the U.S., nearly all of which is provided through optional services." Optional services are "more vulnerable to reductions during periods of state or federal budget constraints," the Bipartisan Policy Center says.
What Greg Murphy's Votes Mean for Older North Carolinians
- 27,200 seniors in North Carolina's 3rd District rely on Medicaid. In 2025, 27,200 seniors in North Carolina's 3rd District were enrolled in Medicaid, KFF data show. Nationally, Medicaid pays for most home care spending, KFF reports. The law Murphy voted for shrinks the federal money behind that coverage.
- Most of North Carolina's 35,329 nursing-home residents depend on Medicaid. KFF's latest count found 35,329 people living in North Carolina's certified nursing facilities. For 60% of them, Medicaid is the main payer. Those are the residents the shelved staffing standard was written to protect. Most of their care is paid with the Medicaid dollars the law reduces.
- 22,300 North Carolinians are already on waiting lists for Medicaid home care. In 2026, 22,300 North Carolinians were waiting for a slot in Medicaid's home care waivers, KFF found. The law's cuts land on a program that already cannot serve everyone who qualifies.
- Hospital assessments that fund North Carolina home care could shrink. North Carolina uses hospital assessments to fund home and community-based services, among other programs. With the law's lower provider-tax ceiling, those programs "may be in jeopardy of facing reductions or being eliminated entirely over time," the North Carolina Medical Journal reported.
Frequently Asked Questions About Greg Murphy on Elder care
What is Greg Murphy's record on elder care under Trump?
Greg Murphy voted for the 2025 law that keeps the nursing-home staffing standard from being enforced until late 2034. His votes also decided the House bill and the February 2025 budget plan that set up the Medicaid cuts. KFF says those cuts could reach 22 million Medicaid enrollees age 50 and older. In North Carolina, 22,300 people wait for Medicaid home care.
Did Greg Murphy vote to delay minimum staffing in nursing homes?
Yes, Greg Murphy's July 3, 2025 vote went to the law that freezes enforcement of the rule until September 30, 2034. The rule set minimum staffing levels for nursing homes. The Consumer Voice, which advocates for residents, says the rule was estimated to save 13,000 lives a year.
Did Greg Murphy vote to make Medicare premiums harder to afford for poor seniors?
Yes, Greg Murphy cast a deciding vote on May 22, 2025 for the House bill that put on hold the rules easing sign-up for Medicare premium aid and for Medicaid, and the final law he voted for kept the pause. A senior who loses that aid could pay "$185 per month in Medicare premiums, or about 20% of income," KFF estimates.
Last updated: 2026-10-27