On July 3, 2025, Mike Collins voted for final passage of the One Big Beautiful Bill Act, whose Medicaid cuts KFF says could affect the 22 million people ages 50 and older on Medicaid. The law bars the nursing-home staffing standard until 2034 and limits the state taxes that help pay nursing homes.
Collins had voted for the budget plan that ordered the Medicaid cut, which passed 217 to 215. In Georgia, Medicaid is the main payer for 71% of nursing-home residents, and 9,063 Georgians were waiting for Medicaid home care in 2026.
Mike Collins's Votes on Nursing Homes, Home Care and Older Adults
- Collins Voted for Medicaid Cuts That Reach Older Georgians and an End to the Nursing-Home Staffing Standard, in July 2025. On July 3, 2025, Mike Collins voted for final passage of H.R. 1, the One Big Beautiful Bill Act, which passed 218 to 214. KFF says its Medicaid cuts could affect the 22 million people ages 50 and older with coverage through Medicaid. The law bars federal enforcement of the 2024 nursing-home staffing rule ending September 30, 2034, which KFF says will reduce federal Medicaid spending by $23 billion over 10 years; the Consumer Voice, an advocacy group for residents, says the minimum staffing rule was estimated to save 13,000 lives annually. Its limits on provider taxes and state-directed payments, which help pay nursing homes, account for $340 billion over ten years.
- Collins Cast One of the Votes That Passed the House Bill by a Single Vote, Including Cuts to Help for Low-Income Seniors, in May 2025. On May 22, 2025, Collins voted for the House version of H.R. 1, which passed 215 to 214, so it could not have passed without his vote. Like the final law, it blocked rules that help low-income seniors enroll in the programs that pay their Medicare premiums and cost sharing, rules collectively estimated to reduce federal Medicaid spending by $122 billion, so that a senior who loses that help could end up paying $185 per month in Medicare premiums, or about 20% of income.
- Collins Voted for the Budget Plan That Ordered the Medicaid Cut, by Two Votes, in February 2025. On February 25, 2025, Collins voted for H.Con.Res. 14, the budget resolution, which passed 217 to 215; a switch by him alone would have tied it, and a tie fails. It told the Energy and Commerce Committee to reduce the deficit by not less than $880,000,000,000. Medicaid pays for almost 70% of all home care spending in the U.S., nearly all of which is provided through optional services, and the Bipartisan Policy Center reports experts expect the law will slow or reverse recent HCBS expansion efforts in states.
What the Medicaid Cuts Mike Collins Voted For Mean for Georgia's Nursing Homes and Home Care
- Nursing homes. Medicaid is the primary payer for 71% of Georgia nursing-home residents, according to KFF.
- Home care waiting list. 9,063 Georgians were already on waiting lists for Medicaid home and community-based care in 2026, according to KFF.
Frequently Asked Questions About Mike Collins on Elder care
What is Mike Collins's record on elder care under Trump?
Mike Collins voted for the One Big Beautiful Bill Act in May and July 2025, and his May vote was one of the 215 that passed the House version by one vote. The law bars the nursing-home staffing standard until 2034 and cuts the Medicaid money that pays for most nursing-home and home care. Medicaid pays for 71% of Georgia nursing-home residents.
Will the law Mike Collins voted for cut home care for seniors in Georgia?
Mike Collins voted for a law that cuts federal Medicaid by an estimated $911 billion over ten years, and most Medicaid home care is optional for states, which makes it more vulnerable to reductions during periods of state or federal budget constraints, the Bipartisan Policy Center says. KFF found that 44 out of the 50 responding states constrain spending on home care already.
What happened to the nursing-home staffing rule?
The law Mike Collins voted for on July 3, 2025 barred the 2024 staffing rule until 2034, and in December 2025 the administration released an interim final rule repealing the nursing home minimum staffing standards, which had required 3.48 hours per resident, per day of total nurse staffing.
Last updated: 2026-10-25