Nick LaLota's July 3, 2025 aye helped enact a Medicaid work rule aimed at the expansion group. KFF calls that group the main route to coverage for people with mental illness or addiction. In New York, 77,687 Medicaid adults with opioid use disorder got coverage through expansion in 2021. LaLota was also among the 215 who passed the House version in May.
Earlier in 2025, a switch of either of LaLota's two budget votes would have tied the resolution, and a tie fails. They gave Energy and Commerce, which oversees Medicaid, its $880 billion savings target. KFF warns the squeeze on states threatens the treatment gains Medicaid paid for.
Nick LaLota's Votes on Medicaid Coverage for Mental Health and Addiction Treatment
- LaLota Voted for a Work Rule on the Medicaid Group Most People in Treatment Rely On. Nick LaLota's aye was among the 218 that sent H.R. 1 to the president on July 3, 2025, over 214 noes. In May he had been one of 215 yeas in a 215 to 214 House vote. The law's work rule exempts people "with a substance use disorder" or "with a disabling mental disorder," and people in a drug or alcohol treatment program. Starting no later than January 1, 2027, it lands on expansion Medicaid, which KFF calls "the primary coverage pathway for people with mental health or substance use disorders." The mental health carve-out covers only "disabling" conditions, so someone whose mental illness is not judged disabling must log hours unless another exemption fits. The Commonwealth Fund expects many people cut off who "will remain eligible for Medicaid but who did not successfully complete the paperwork." Arkansas ran a work rule first; KFF found "over 18,000 people losing coverage."
- LaLota's Deciding Budget Votes Set the $880 Billion Medicaid Committee Target. The House adopted H.Con.Res. 14 twice in 2025: by 217 to 215 on February 25 and by 216 to 214 on April 10. LaLota's yes counted in both. Any one flip, his included, forces a tie, and a tie fails. The text sent the Medicaid committee a goal: "reduce the deficit by not less than $880,000,000,000." States widened mental health and addiction care through Medicaid. KFF says the law's cuts and "a more tenuous fiscal climate for states may make those gains harder to sustain." Nationally, Medicaid covers "over half (56%) of those receiving medication" for opioid addiction.
What Nick LaLota's Votes Put at Risk for New Yorkers in Recovery
- The work rule's target group numbers 44,100 in New York's 1st District. Medicaid's expansion group held 44,100 people in New York's 1st District in 2025, per KFF. That is the group the work rule targets. Starting by January 1, 2027, anyone among them in mental health care whose condition is not judged disabling must report hours to stay covered, unless another exemption applies. The law does exempt people with a substance use disorder.
- Two-thirds of New York Medicaid adults with opioid use disorder are in the targeted group. KFF data show 116,380 adults on New York Medicaid with an opioid use disorder diagnosis in 2021. Of them, 77,687, or 67%, were covered through expansion. Medication for opioid use disorder lowers the risk of overdose death, KFF notes, and getting it depends on staying covered.
- 35,147 New Yorkers got opioid addiction medicine through Medicaid expansion. In 2021, 51,008 adults on New York Medicaid were taking medicine for opioid addiction, per KFF. Expansion paid for 35,147 of them, 69%. Those are the patients most exposed when the work rule and the cuts take hold.
Frequently Asked Questions About Nick LaLota on Mental health and addiction
What is Nick LaLota's record on mental health and addiction under Trump?
Nick LaLota voted for the One Big Beautiful Bill Act at both of its 2025 House passage votes, in May and July. Its Medicaid work rule falls on the expansion group, the largest source of coverage for mental health and addiction care. From January 1, 2027, a patient whose mental illness falls short of disabling has to report work hours or qualify another way. His deciding 2025 budget votes gave the committee over Medicaid its $880 billion savings target, and KFF says the law's cuts strain states' treatment gains.
Could someone on Long Island in opioid treatment lose Medicaid because of Nick LaLota's vote?
Yes, if the paperwork fails: Nick LaLota voted for a work rule that, from January 1, 2027, exempts people who have a substance use disorder or are in a treatment program, but the Commonwealth Fund expects states to vary in how well they verify exemptions. In New York, 69% of Medicaid adults getting opioid addiction medicine in 2021 were covered through expansion, the group the rule targets. Missing a verification step can end coverage and the medicine with it.
Are New Yorkers with depression or anxiety exempt from the Medicaid work rule Nick LaLota voted for?
Not automatically: under the law Nick LaLota voted for, a mental disorder exempts someone only when it is "disabling" in the law's terms. Someone whose depression or anxiety falls short of disabling must still report 80 hours a month from January 1, 2027, unless another exemption fits. The Commonwealth Fund says the rule will reach more than 20 million adults in 40 states and D.C. It expects eligible people to lose coverage over paperwork.
Last updated: 2026-10-27