Mike Carey and the One Big Beautiful Bill Act: Ohio Loses $32.6 Billion in Medicaid After His One-Vote House Margin and Final-Passage Aye

KFF's estimate of Ohio's Medicaid loss from the One Big Beautiful Bill Act: $32.6 billion in federal funds across a decade. On May 22, 2025, the House passed it by one vote, 215 to 214, and Mike Carey's yea was that margin. Carey cast his final-passage aye on July 3, 2025.

Carey's yea was also the margin on the budget resolution, both in February and in April 2025, and on two July procedural votes that brought up the final text. Nine months after enactment he voted for H.Res. 1156, a tribute to the law. Medicaid enrolled 227,600 people in Ohio's 15th District in 2025.

Mike Carey's House Votes on the One Big Beautiful Bill Act, in Order

• Carey's February 2025 Yea Adopted a Budget Plan With an $880 Billion Savings Target for the Medicaid Committee. Three roll calls fell on February 25, 2025. Roll call 46, the previous question on H.Res. 161, the rule taking up the budget: Carey, yea. Roll call 47, adopting that rule: Carey, aye. Roll call 50, H.Con.Res. 14 itself: Carey, yea, and it was adopted 217 to 215. A lone Carey switch produces a tie, and a tie loses. Under the resolution, Energy and Commerce, which writes Medicaid law, had to "reduce the deficit by not less than $880,000,000,000" in ten years. Agriculture, which writes SNAP law, owed no less than $230 billion. And the tax panel, Ways and Means, could run deficits up by as much as $4.5 trillion.
• April 2025: Carey's Yeas Were the Margin on H.Res. 313 and the Senate-Amended Budget. Roll call 93, on April 9, 2025, the previous question on H.Res. 313: Carey, yea. Roll call 94, adopting H.Res. 313, which took up the Senate-amended budget: Carey, aye, at 216 to 215. Roll call 100, on April 10, concurring in the Senate amendment: Carey, yea, at 216 to 214. Both 94 and 100 turned on margins Carey's switch alone would have reversed. The committee orders stayed the same. The Medicaid cuts came in the law Carey voted for on July 3, which the budget office scores at $911 billion over ten years, KFF reports.
• Carey's Yea Was Among the 215 That Carried the House Bill by One Vote, in May 2025. Six roll calls fell on May 22, 2025. First came a pair of consideration questions on the H.R. 1 rule, roll calls 139 and 140: Carey said yea to each, and they carried 217 to 211 and 216 to 211. Next, roll call 141, the previous question: Carey, yea, at 213 to 211, a margin his vote decided. Roll call 142, the rule: Carey, aye. Roll call 144: Carey voted against the motion to recommit; the tally against it was 216, with 212 for. Roll call 145, H.R. 1: Carey, yea, and it passed 215 to 214, one present. Senators rewrote it, and Carey voted for their version in July. That version's Medicaid provisions add 7.5 million uninsured people in 2034, by the budget office estimate KFF reports. It also blocked Planned Parenthood's Medicaid payments for a "1-year period".
• Carey Decided Two July Rule Votes on the Final Version, Then Voted Aye on Final Passage. Roll call 186, on July 2, 2025, whether to consider H.Res. 566, the rule governing the Senate-passed text: Carey, yea, at 212 to 211. Roll call 187, the previous question: Carey, yea, at 214 to 212. Had Carey alone flipped, 186 fails outright and 187 ties. Roll call 188, an amendment to the rule: Carey, aye. Roll call 189, the rule, on July 3: Carey, yea. Roll call 190, final passage, also July 3: Carey, aye, at 218 to 214. The president signed it July 4, 2025, making it Public Law 119-21. KFF reports the budget office's estimate that 10 million more people go uninsured in 2034 because of the law. CBPP: "The megabill cuts SNAP by $187 billion or about 20 percent by 2034."
• Carey Said Yea in 2026 to H.Res. 1156, Which Hails the Law as Tax Relief for Working Families. Roll call 121, on April 16, 2026, H.Res. 1156: Carey, yea, and it was adopted 219 to 207. The text names the law the "Working Families Tax Cuts". It claims the law "will result in a 15 percent tax cut for Americans whose income is in the bottom 40 percent." ITEP's 2026 numbers: "For the poorest fifth of Americans, the average tax change from OBBBA is a small tax increase". The richest 1 percent average a cut topping $70,000.

What the One Big Beautiful Bill Act Costs Ohio After Mike Carey's Votes, Topic by Topic

• Medicaid: Ohio surrenders $32.6 billion in federal funds. Ohio's slice of the national Medicaid cut is $32.6 billion over ten years, or 13% of expected federal funds, in KFF's allocation. That reaches 227,600 enrollees in Ohio's 15th District. Details: Mike Carey on health care.
• Hospitals: $2.16 billion a year in Ohio payments exceed the new caps, and rural Ohio loses $5.62 billion. KFF puts roughly $2.16 billion a year of federal Ohio hospital spending over the law's payment ceilings. Rural Ohio's ten-year Medicaid loss is $5.62 billion. Details: Carey's hospital votes.
• Coverage: 340,000 more Ohioans uninsured in 2034. In KFF's projection, the law alone takes coverage from enough people to raise Ohio's uninsured count by 340,000 in 2034. Details: Carey on health care.
• Food aid: 98,000 Ohioans lose SNAP, and the state owes about $150 million in fiscal 2028. CBPP's estimate is 98,000 Ohioans losing food benefits. Ohio also owes roughly $150 million toward SNAP benefits in fiscal 2028, the first year of the cost shift, which begins October 2027. Details: Carey on food assistance.
• Poverty: 81,100 children in Ohio's 15th District depend on Medicaid. There are 81,100 children on Medicaid in Ohio's 15th District, KFF's 2025 figures show. Households at the bottom lose resources under the law while the top tenth gains. Details: Carey on homelessness and poverty.
• Medicare: 2.5 million Ohio enrollees, a hospital fund that runs short a quarter sooner. Medicare covered 2,535,073 Ohioans in 2024. The law's tax changes, more than anything else, moved the hospital fund's exhaustion date one quarter sooner, though it stays in 2033. Details: Carey on Medicare.
• Nursing homes: Medicaid pays first for 65% of Ohio's 67,366 residents. Ohio's 67,366 nursing-facility residents mostly rely on Medicaid; it is first payer for 65%. The staffing standard is shelved until 2034. Details: Carey on elder care.
• Disability: 25,400 Medicaid enrollees with disabilities in Ohio's 15th District rely on a program losing $32.6 billion. Ohio's 15th District has 25,400 people with disabilities on Medicaid, a program that loses $32.6 billion in federal funds across Ohio over ten years. Details: Carey on disability rights.
• Addiction: expansion covers 73,170 Ohio Medicaid adults with opioid use disorder, and paperwork can cost them coverage. In 2021, expansion was the coverage source for 73,170 of the 116,325 Ohio Medicaid adults diagnosed with opioid use disorder, or 63%. The work rule exempts addiction, but eligible people can still lose coverage over paperwork, the Commonwealth Fund warns. Details: Carey on mental health and addiction.
• Families: 49,000 children in Ohio's 15th District short of the full child tax credit. Columbia's estimate for Ohio's 15th District: 49,000 children, 28%, cannot get the whole credit. Details: Carey on child care and families.
• Social Security: 138,055 beneficiaries in Ohio's 15th District, $168.6 billion in added costs. Social Security paid 138,055 people in Ohio's 15th District in December 2024. The chief actuary says the law tacks $168.6 billion onto the program's ten-year costs. Details: Carey on Social Security.
• Student loans: Ohioans leaving SAVE pay an average of $1,982 more a year. CAP's Ohio figure for the average SAVE-to-RAP payment jump is $1,982 a year. Details: Carey on student debt.
• Veterans: Ohio veterans in SNAP households lose their exemption from the time limit. CBPP counts 45,000 Ohio veterans in SNAP households. The law ended the veterans' exemption, so those among them without a disability or another exemption now face the time limit. Details: Carey on veterans.
• Energy: Ohio homes could pay about $190 more a year by 2035. CNBC reported Energy Innovation's projection: by 2035, an average Ohio home could spend about $190 a year more on energy because of the law's energy provisions. The law ends the tax credits for home energy improvements.

Frequently Asked Questions About Mike Carey on One Big Beautiful Bill

Last updated: 2026-10-27

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