In 2025 Pete Ricketts voted against several chances to stop the One Big Beautiful Bill Act's Medicaid cuts to older Americans, including a point of order against cuts that take away health care from seniors in nursing homes and a motion to eliminate any provisions that would lead to nursing home closures, and then cast one of the 50 votes that passed the law on July 1, 2025. Medicaid is the primary payer for 54 percent of Nebraska nursing-home residents.
The Nebraska senator voted to confirm Mehmet Oz, whose agency in December 2025 repealed the nursing home minimum staffing standards, and he wrote that blocking the staffing rule was a priority: "We reversed Biden's harmful rule by passing the OBBB." As Nebraska governor in 2017, he vetoed money for Medicaid provider rates, a cut that fell on nursing homes the Legislature's budget chair called financially stressed.
Pete Ricketts's Votes, Actions and Statements on Nursing Homes, Home Care and Caregivers
- Ricketts Cast a Deciding Vote for the Medicaid Cuts and a Ban on the Nursing-Home Staffing Standard, in July 2025. On July 1, 2025, Pete Ricketts voted for H.R. 1, which passed 50 to 50 with the Vice President breaking the tie. Its section 71111 bars the Department of Health and Human Services from enforcing the 2024 nursing-home staffing rule through September 30, 2034. KFF says the law's Medicaid cuts could affect the 22 million people ages 50 and older on Medicaid, and that its moratorium on provider taxes, which are in place for nursing facilities in 46 states, and its new limits on state-directed payments account for $340 billion in reduced federal Medicaid spending over 10 years.
- Ricketts Voted Against a Rule Protecting Seniors in Nursing Homes From Medicaid Cuts in February 2025. On February 20, 2025, Ricketts voted no on Senator Tammy Baldwin's point of order "against legislation that would take away health care from seniors, including those receiving care in nursing homes, through cuts to the Medicaid program." It failed 48 to 52. Medicaid is the primary payer for 63% of nursing facility residents nationally.
- Ricketts Voted Against Removing Provisions That Would Close Nursing Homes, in June 2025. On June 30, 2025, Ricketts voted no on Senator Jack Reed's motion to send H.R. 1 back to committee with changes that would eliminate provisions that change state provider taxes and that would eliminate any provisions that would lead to any nursing home closures. It failed 48 to 52. Nebraska's hospital tax is among those KFF expects to shrink under the new limits.
- Ricketts Voted Against Striking the Medicaid Cuts That Pay for Home Care, in June 2025. On June 30, 2025, Ricketts voted no on Senator Ron Wyden's motion with instructions that would strike any provision that cuts funding for Medicaid. It failed 47 to 53. 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 says that optional status makes these programs more vulnerable to reductions during periods of state or federal budget constraints.
- Ricketts Voted Against Protecting Seniors' Medicaid and Family Caregivers in April 2025. On April 4, 2025, Ricketts voted no on an amendment for a reserve fund "relating to preventing reduction in enrollment or benefits for individuals enrolled in Medicaid, including seniors, children, families, individuals with disabilities, veterans, and military families," which failed 48 to 51. On April 5 he voted no on an amendment for a reserve fund "to prevent increased barriers to American caregivers, including individuals caring for seniors, children, home care workers," which failed 49 to 50, so his vote was one it could not lose. The budget plan went forward without either protection, and the Bipartisan Policy Center reports experts expect the law will slow or reverse recent HCBS expansion efforts in states.
- Ricketts Voted to Keep Medicare's Prior-Authorization Pilot in July 2026. On July 16, 2026, Ricketts voted against taking up S.J.Res. 198, which would have overturned WISeR, a model that since January 2026 requires prior approval for some services in traditional Medicare in six states: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. It failed 46 to 50. Two vendors together denied 5,944 prior authorization requests in the first three months of the program.
- Ricketts Voted to Confirm Mehmet Oz, Whose Agency Repealed the Nursing-Home Staffing Standard, in April 2025. On April 3, 2025, Ricketts voted to confirm Mehmet Oz to run the Centers for Medicare & Medicaid Services. On December 2, 2025, his agency released an interim final rule repealing the nursing home minimum staffing standards, including 3.48 hours per resident, per day of total nurse staffing and a registered nurse on site around the clock.
- As Nebraska Governor, Ricketts Vetoed Medicaid Provider Rate Money That Nursing Homes Depended On, in 2017. In a May 15, 2017 veto message, Nebraska Governor Pete Ricketts struck $33.6 million in general funds for Medicaid, behavioral health, child welfare and developmental disability providers, which the Legislature's news service said amounts to a 3 percent cut in provider rates. The Legislature's attempt to restore the money failed on a vote of 27-21, short of the 30 votes needed. Appropriations Chair John Stinner said Nebraska's Medicaid provider rates were already the sixth lowest of the reporting states and that nursing homes, particularly in rural areas, were stressed financially by those low rates. From 2015 to early 2023, while he was governor and just after, 79 facilities (nursing homes and assisted living facilities) closed in Nebraska, a loss of more than 3,000 beds, and the Nebraska Health Care Association described a history of inadequate Medicaid reimbursement rates.
- Ricketts Said Blocking the Nursing-Home Staffing Rule Was His Priority, in 2025. In a September 26, 2025 column, Ricketts wrote of the staffing rule that he "made it a priority to fix," adding: "We reversed Biden's harmful rule by passing the OBBB." In an August 15, 2025 column he had written that the law "cleans up burdensome Biden-era mandates" for long-term care facilities, including the 24-hour registered nurse requirement. When a federal judge in Texas overturned the rule in April 2025, only about 1 in 5 nursing facilities met its minimum staffing standard, KFF found, and the Consumer Voice, an advocacy group, says the standards were estimated to save 13,000 lives annually.
What the Medicaid Cuts Pete Ricketts Voted For Mean for Nebraska's Nursing Homes
- Nursing homes. Medicaid is the primary payer for 54 percent of residents of Nebraska's certified nursing facilities, where 9,771 people lived in KFF's most recent count.
- Closures. Eleven Nebraska nursing homes and assisted living facilities closed in 2022 alone, most in rural communities, KLKN reported from Nebraska Health Care Association figures.
Frequently Asked Questions About Pete Ricketts on Elder care
What is Pete Ricketts's record on elder care under Trump?
Pete Ricketts voted against a point of order protecting seniors in nursing homes, against motions to strike the Medicaid cuts and the provisions that would close nursing homes, and for the One Big Beautiful Bill Act, which bars the nursing-home staffing standard until 2034. Ricketts also voted to confirm Mehmet Oz, whose agency repealed the staffing standards, and wrote that blocking the rule was a priority he passed into law.
Did Pete Ricketts vote to end the nursing-home staffing rule?
Yes. Pete Ricketts voted for the One Big Beautiful Bill Act, whose Section 71111 bars enforcement of the 2024 nursing-home staffing rule through September 30, 2034. The rule would have required 3.48 hours per resident, per day of total nurse staffing before the Centers for Medicare & Medicaid Services repealed it.
What did Pete Ricketts do on nursing-home funding as Nebraska governor?
As Nebraska governor, Pete Ricketts vetoed $33.6 million for Medicaid and other provider rates in 2017, which amounts to a 3 percent cut in provider rates, and the Legislature fell three votes short of overriding him. The Legislature's budget chair warned that rural nursing homes were already stressed financially by those low rates.
Last updated: 2026-10-25