As Texas attorney general, Ken Paxton sued in August 2024 to stop the federal minimum-staffing standard for nursing homes, and a federal judge in Texas overturned it in April 2025. He also led the multistate lawsuit that ended, on September 23, 2026, with a court vacating the provisions of a federal disability rule that protect people from being kept in institutions when they could be served at home.
In July 2025 Paxton praised the One Big Beautiful Bill Act, which bars the staffing standard until 2034 and cuts the Medicaid money that pays for most nursing-home care. In Texas, Medicaid is the primary payer for 62 percent of nursing-home residents.
Ken Paxton's Lawsuits and Statements on Nursing Homes and Home Care
- Paxton Sued to Stop the Federal Nursing-Home Staffing Rule in 2024, and a Texas Judge Struck It Down. On August 14, 2024, Ken Paxton sued the Biden Administration to stop a new Centers for Medicare and Medicaid Services rule setting minimum staffing levels for nursing homes. In April 2025 a federal judge granted Attorney General Paxton's request to vacate the rule. The rule would have required 3.48 hours per resident, per day of total nurse staffing, and KFF found that only about 1 in 5 nursing facilities met the now-overturned minimum. The Consumer Voice, an advocacy group for residents, says the rule was estimated to save 13,000 lives annually.
- Paxton's Section 504 Lawsuit Ended in September 2026 With Federal Protections Against Unneeded Institutionalization Removed. On September 26, 2024, Ken Paxton led a multistate suit against the U.S. Department of Health and Human Services over its Section 504 disability rule; the case began when 17 Republican-led states sued. After the Justice Department switched sides and agreed with the states that the requirement should be undone, the court on September 23, 2026 granted a joint motion filed by the Department of Justice and the plaintiffs. The order vacated the entire integration provision which includes specific prohibitions against segregation and institutionalization. LeadingAge, an association of nonprofit aging-services providers, said it is concerned about the ability of older adults with disabilities to continue to receive services in their communities. Section 504, the Americans with Disabilities Act and the Supreme Court's Olmstead decision still apply.
- Paxton Praised the Law That Bars the Nursing-Home Staffing Standard Until 2034. Ken Paxton posted on July 3, 2025 that "President Trump's Big Beautiful Bill is HISTORIC legislation," after posting on July 1 that the Senate-passed bill was "One step closer to massive tax cuts." The law he praised forbids the Department of Health and Human Services to implement, administer, or enforce the 2024 staffing rule through September 30, 2034. KFF says that ban will reduce federal Medicaid spending by $23 billion over 10 years, and that the law's Medicaid cuts could affect the 22 million people ages 50 and older with Medicaid coverage.
- The Law Paxton Praised Puts Medicaid Home Care at Risk. The One Big Beautiful Bill Act that Ken Paxton praised cuts the Medicaid money states use for optional services, and home and community-based care for seniors is largely an optional Medicaid benefit, the Bipartisan Policy Center notes. Experts expect the law will slow or reverse recent HCBS expansion efforts in states, and in nearly 30 states limits on hours or visits, reduced provider payment rates, and new or lower spending caps have been enacted or proposed (Bipartisan Policy Center, August 2026).
- The Law Paxton Praised Makes It Harder for Low-Income Seniors to Get Help With Medicare Premiums. The law Ken Paxton praised blocks two rules that made it easier for low-income seniors to enroll in Medicaid programs that pay their Medicare premiums. KFF says the two moratoriums are collectively estimated to reduce federal Medicaid spending by $122 billion, and an earlier Congressional Budget Office analysis found 1.3 million fewer Medicare beneficiaries would also have Medicaid coverage in 2034.
What Ken Paxton's Lawsuits and the Law He Praised Mean for Older Texans
- Nursing homes. Texas had 87,711 residents in certified nursing facilities in KFF's most recent count, the residents the staffing standard was written to protect.
- Home care. In 2026, 194,316 Texans were already waiting for Medicaid home and community-based care, and Texas does not screen people on its interest lists for eligibility, KFF reports.
Frequently Asked Questions About Ken Paxton on Elder care
What is Ken Paxton's record on elder care under Trump?
Ken Paxton's lawsuit got the federal nursing-home staffing standard struck down in April 2025, and the Section 504 suit he led ended in September 2026 with federal integration protections for older adults with disabilities vacated. He praised the One Big Beautiful Bill Act in July 2025, a law that bars the staffing standard through 2034 and cuts the Medicaid money that pays for most nursing-home and home care. In Texas, nearly 200,000 people were already waiting for Medicaid home care in 2026.
Did Ken Paxton sue to block nursing home staffing requirements?
Yes. Ken Paxton sued on August 14, 2024 to stop the federal rule setting minimum nurse staffing in nursing homes, and a federal judge granted his request to vacate it in April 2025. When the Centers for Medicare & Medicaid Services issued an interim final rule rescinding part of the minimum staffing rule in December 2025, it cited Congress's postponement of the rule and two federal court cases that found parts of the rule invalid, the Consumer Voice reported.
What happened to the Section 504 disability lawsuit Ken Paxton led?
Ken Paxton's Section 504 lawsuit, filed in federal court in Texas in 2024, ended its challenge to the rule's integration provisions on September 23, 2026, when the court granted a joint motion by the Justice Department and the plaintiff states and vacated those provisions. Texas Public Radio reported that the federal government was originally the defendant and then switched sides.
Last updated: 2026-10-25