On July 3, 2025, Richard Hudson voted for the final One Big Beautiful Bill Act, under which expansion adults on Medicaid keep coverage only by logging 80 monthly hours of jobs, service, training or school, or by having the state sign off on an exemption, a rule the Centers for Medicare and Medicaid Services expects to cut enrollment by 2.3 million people in fiscal 2027. The law exempts people who are blind or disabled, people "with a disabling mental disorder" or "with a serious or complex medical condition," and those whose physical, intellectual or developmental disability significantly impairs daily living, and CMS's rule adds that a qualifying condition must significantly impair the ability to work, with the state verifying it, Georgetown's Center for Children and Families explains.
Hudson's earlier votes set this up. On February 25 and April 10, 2025, his votes decided the budget resolution giving the committee over Medicaid a savings goal of at least $880 billion, and on May 22 his vote decided House passage. In North Carolina's 9th District, 27,300 people qualified for Medicaid through a disability in 2025.
Richard Hudson's Votes on Medicaid Work Rules and Home Care for People With Disabilities
- In July 2025 Hudson Voted to Put Disabled Adults in Medicaid Expansion Under Work Rules Unless Exempt. Richard Hudson's yes on May 22, 2025 was needed for H.R. 1 to pass the House 215 to 214; on July 3, 2025, his vote went to the final law, approved 218 to 214. It requires expansion adults to show 80 hours of qualifying activity each month, with exemptions that include one for someone "with a physical, intellectual or developmental disability that significantly impairs their ability to perform 1 or more activities of daily living." Under CMS's rule, the state must verify the exemption, so a disabled adult who cannot get the paperwork through loses coverage like anyone else; CMS projects that the requirement means "enrollment would be reduced by 2.3 million individuals in FY 2027."
- Hudson Twice Decided the Budget Vote Ordering $880 Billion From Medicaid's Committee, Putting Home Care at Risk. Two budget roll calls went Hudson's way by a single vote each: H.Con.Res. 14 itself, adopted 217 to 215 on February 25, 2025, and the Senate's amended text, adopted 216 to 214 on April 10; either time, his switch alone would have produced a tie, which defeats a resolution. The resolution's instruction to the Energy and Commerce Committee: "reduce the deficit by not less than $880,000,000,000". The aides and supports that keep disabled people in their own homes rather than group facilities, known as home and community-based services, are "largely an optional Medicaid benefit," the Bipartisan Policy Center notes, which leaves them "more vulnerable to reductions during periods of state or federal budget constraints"; experts it cites expect the law to "slow or reverse recent HCBS expansion efforts" by states.
What Richard Hudson's Votes Mean for North Carolinians With Disabilities
- Medicaid covers 27,300 disabled residents of Hudson's district. KFF's district data list 27,300 Medicaid enrollees in North Carolina's 9th District who qualify through a disability, part of 244,800 enrollees there in 2025. They come into Medicaid outside the expansion group that the work rule reaches, but their care runs on the same federal Medicaid dollars, which KFF's allocation of the law's cut shrinks by $22.5 billion in North Carolina over ten years.
- Disabled adults among North Carolina's 685,000-plus expansion enrollees must prove an exemption. Expansion has brought more than 685,000 additional North Carolinians into Medicaid, the North Carolina Medical Journal reported, and those adults are the group the work rule covers. Under the federal rule, an adult whose disability is not already on record has to document that the condition seriously limits work, and Georgetown's Center for Children and Families warns that fewer people will qualify as medically frail under that standard.
- 22,300 North Carolinians are waiting for Medicaid home care the cuts put at risk. In 2026, 22,300 North Carolinians sat on waiting lists for Medicaid-funded care at home, by KFF's count. Those slots run on optional-benefit dollars, the kind the Bipartisan Policy Center finds most exposed to cuts, and people stuck on the list either wait at home without paid help or move into institutions.
- 22,274 disabled workers in Hudson's district draw Social Security. The Social Security Administration counted 22,274 disabled-worker beneficiaries in North Carolina's 9th District and 278,281 statewide in December 2024. The program's chief actuary estimates the law adds $168.6 billion to Social Security's combined retirement and disability costs through 2034.
Frequently Asked Questions About Richard Hudson on Disability rights
What is Richard Hudson's record on disability rights under Trump?
Richard Hudson cast deciding votes in 2025 on the One Big Beautiful Bill Act's budget resolution in February and April and on its May 22 House passage, then voted for the final law on July 3. Under the law, a disabled adult in the expansion group either logs monthly work hours or qualifies for an exemption, which CMS's rule has the state verify, and CMS projects 2.3 million fewer enrollees in fiscal 2027. Separately, 27,300 people in North Carolina's 9th District qualify for Medicaid through a disability, outside the expansion group the work rule covers.
When does the Medicaid work rule start for disabled North Carolinians under the law Richard Hudson voted for?
The work rule in the law Richard Hudson voted for must be running in North Carolina and every other state "no later than January 1, 2027," so disabled expansion adults who do not log the hours need an exemption by then, verified by the state under CMS's rule. Two other changes arrive around the same time, KFF reports: renewals every six months for expansion adults, for renewals on or after December 31, 2026, and a one-month limit on retroactive coverage from January 1, 2027.
How did Richard Hudson's budget votes put home care for people with disabilities at risk?
On February 25 and April 10, 2025, Richard Hudson's votes decided H.Con.Res. 14, whose target for the committee over Medicaid was $880 billion or more, and home care is an optional Medicaid benefit that the Bipartisan Policy Center says is especially exposed when budgets shrink. North Carolina already had 22,300 people waiting for Medicaid home care in 2026.
Last updated: 2026-10-27