The One Big Beautiful Bill Act works by sending states less federal money for Medicaid, $911 billion less over ten years, and Maria Elvira Salazar, the Republican who represents Florida's 27th District, was the 215th vote in a 215-to-214 House passage on May 22, 2025, before voting for the Senate-rewritten law on July 3. By KFF's state-by-state math, Florida gives up $13.6 billion.
The 2025 budget plan behind those cuts handed each House committee a savings target, and Salazar's votes in February and April 2025 decided both versions of the plan that demanded at least $880 billion from the panel in charge of Medicaid law. The law she voted for on July 3 also sets a ceiling on the supplemental payments states route to hospitals; KFF puts roughly $394 million of Florida's yearly federal hospital-payment money over it. Medicaid covered 153,100 of Salazar's constituents in 2025, 19% of the district.
Maria Elvira Salazar's Votes on the Medicaid Cuts and Hospital Payment Caps
- Medicaid Funding Cut: The Law Takes $13.6 Billion From Florida After Salazar's Deciding House Vote and Her Vote for Final Passage. The House tally on May 22, 2025 was 215 to 214, with one member voting present, and Maria Elvira Salazar was among the 215, so a no from her would have sunk H.R. 1 on the floor. On July 3, 2025 she said yes again, and the Senate-amended bill cleared 218 to 214. The mechanism is plain: Washington sends states less for Medicaid. The Congressional Budget Office pegs the reduction at $911 billion over ten years and expects 10 million more Americans uninsured in 2034 as a result. Florida's portion, as KFF divides the national total, is $13.6 billion, a 5% bite out of the federal Medicaid funding Florida was on track to collect.
- Budget Targets and Hospital Payment Caps: Salazar's Deciding Votes Set the $880 Billion Energy and Commerce Savings Target, and Her July Vote Enacted Limits on Florida Hospital Payments, in 2025. Both budget resolution votes came down to two-vote margins: H.Con.Res. 14 carried 217 to 215 on February 25, 2025, and its Senate-amended version 216 to 214 on April 10. Salazar voted yes each time, and had she flipped, either would have deadlocked, which in the House means defeat. The resolution's order to Energy and Commerce, the panel that controls Medicaid law, was to "reduce the deficit by not less than $880,000,000,000". Salazar also voted for the May 2025 rule setting up floor debate on H.R. 1. The finished law, approved with her vote on July 3, 2025, squeezed two financing tools. Limits on the provider taxes states levy to raise their own Medicaid share cost $191 billion in federal matching money over ten years, the Congressional Budget Office estimates. A new cap on state-directed payments, the extra Medicaid money states pass to hospitals, means that "payment rates for hospital services will decrease in at least 37 states" once it takes hold on January 1, 2028, KFF found.
How the Medicaid Changes Maria Elvira Salazar Voted For Reach Florida's 27th District and Florida Hospitals
- 153,100 residents of Florida's 27th District rely on the Medicaid program the law cuts. Inside Florida's 27th District, Medicaid had 153,100 enrollees in 2025 by KFF's count, including 49,200 seniors and 42,800 adults, or 19% of everyone living there. Each federal Medicaid dollar the law withholds from Florida is a dollar less behind their checkups, prescriptions and nursing-home stays.
- Florida's uninsured count rises by 590,000 in 2034 under the law alone. KFF's projection for 2034 is 590,000 additional Floridians without coverage from this law by itself (KFF's range runs from 440,000 to 730,000), which pushes Florida's uninsured rate up 2 points. Without insurance, an asthma inhaler or an emergency room visit turns into a full-price bill.
- Florida hospitals have $394 million a year in Medicaid payments above the new cap, and Public Citizen flags three as at risk. Florida's hospitals draw about $420.6 million a year in federal state-directed payment money, and KFF calculates roughly $394 million of it sits over the new cap. Public Citizen marks Homestead Hospital, Miami Jewish Health and Lakeside Medical Center in Belle Glade as at risk, since each combines heavy Medicaid and low-income caseloads with operating losses; for a hospital already in the red, a smaller Medicaid check leaves less to keep units staffed and open.
- Rural Florida loses $613 million in federal Medicaid money over ten years. Rural Florida's federal Medicaid dollars shrink by about $613 million over ten years under the law, KFF estimates. That is a decade of smaller Medicaid payments to the rural clinics and hospitals where patients in farm and small-town Florida get care, and less money to keep their doors open.
Frequently Asked Questions About Maria Elvira Salazar on Health Care
What is Maria Elvira Salazar's record on health care under Trump?
Maria Elvira Salazar supplied the deciding vote when the House passed the One Big Beautiful Bill Act 215 to 214 in May 2025 and then cast a yes for the final law in July, whose Medicaid provisions remove $911 billion in federal spending over a decade, $13.6 billion of it from Florida by KFF's allocation. Her votes in February and April 2025 also decided both versions of the budget resolution that set the savings target for Energy and Commerce, the panel over Medicaid. KFF projects the law will leave 590,000 more Floridians uninsured in 2034.
How does the law Maria Elvira Salazar voted for change health coverage for refugees and asylees in Miami-Dade?
Maria Elvira Salazar cast her July 3, 2025 yes for a law that, from October 1, 2026, limits Medicaid among lawfully present immigrants to green-card holders, some Cuban and Haitian entrants and a few other groups, leaving refugees and people granted asylum off the list, and KFF's tracker shows Florida must carry out those limits. For tax years after 2026, the same law bars refugees, asylees and Temporary Protected Status holders from the marketplace premium tax credits that lower monthly premiums, a change the Congressional Budget Office expects to leave 900,000 more people uninsured in 2034.
Will Florida Medicaid patients get less help with past medical bills because of Maria Elvira Salazar's vote?
Yes: the law Maria Elvira Salazar voted for shrinks the window for retroactive Medicaid coverage from the 90 days before an application to two months for traditional enrollees, starting January 1, 2027, and KFF lists Florida among the states that must apply that limit. A Florida patient hospitalized before applying can be left with bills from the weeks the shorter window no longer reaches. The Congressional Budget Office expects the change to add 100,000 people to the uninsured in 2034.
Last updated: 2026-10-27