Richard Hudson's July 3, 2025 vote went to the One Big Beautiful Bill Act in its final form, a law whose Medicaid cuts KFF says "could affect the 22 million people ages 50 and older with coverage under the Medicaid program" and which puts the federal nursing-home staffing standard out of reach of enforcers through September 30, 2034. North Carolina's certified nursing facilities house 35,329 people, and for 60% of them Medicaid foots most of the bill.
The bill reached that point through three Hudson votes. In February 2025 his vote decided the House budget resolution ordering $880 billion from the committee over Medicaid, which pays for most home care; in May his vote decided House passage of a bill that freezes two Medicaid enrollment rules, one of them for low-income seniors' Medicare costs; and in July he voted for the law.
Richard Hudson's Votes on Nursing Homes, Home Care and Medicaid for Older Adults
- Hudson Voted to Freeze Nursing-Home Staffing Rules for a Decade and Cut the Medicaid Funding Behind Most Nursing-Home Care. Richard Hudson's July 3, 2025 vote helped the final H.R. 1 clear the House 218 to 214. Washington may not enforce the 2024 nursing-home minimum staffing rule before September 30, 2034 under the law, and KFF explains that this cements a court decision that had already struck down central pieces of the rule. Blocking the rule saves the federal government $23 billion in Medicaid over ten years, KFF reports, money that would have gone to the added staff the rule required; the residents' advocacy group Consumer Voice says "The minimum staffing rule was estimated to save 13,000 lives annually." Nursing homes also lean on two financing tools the law restricts, provider taxes and state-directed payments; those restrictions account for $340 billion more in federal cuts across the decade, cuts that also fall on hospitals and other providers.
- In May 2025 Hudson Gave the House Bill a Vote It Needed, Freezing Premium Help for Low-Income Seniors. On May 22, 2025, Hudson voted yes on H.R. 1, which the House passed 215 to 214, a margin his vote was required for. Its text, kept in the final law, halts most of two Biden-era rules, one that had eased low-income seniors' path into the Medicare Savings Programs and a broader one on Medicaid eligibility and enrollment. As enacted with Hudson's second yes, on July 3, 2025, the two rules on hold are "collectively estimated to reduce federal Medicaid spending by $122 billion," KFF reports, and KFF's example of an older adult who loses that help faces a $185 monthly Medicare premium, roughly 20% of what that person lives on.
- Hudson Decided the February 2025 Budget Vote That Set Up Cuts to Home Care's Main Payer. On February 25, 2025, Hudson voted to adopt H.Con.Res. 14, which carried 217 to 215; without his yes the count ties, and a tied resolution fails. It directed the Energy and Commerce Committee to "reduce the deficit by not less than $880,000,000,000". KFF notes that "Medicaid pays for almost 70% of all home care spending in the U.S., nearly all of which is provided through optional services," and because states can drop optional services, the Bipartisan Policy Center finds home care "more vulnerable to reductions during periods of state or federal budget constraints."
What Richard Hudson's Votes Mean for Older Adults in North Carolina's Nursing Homes and at Home
- 22,500 seniors in Hudson's district count on the Medicaid program the law cuts. In North Carolina's 9th District, 22,500 seniors were enrolled in Medicaid in 2025, KFF's district figures show; for many that means Medicaid covers a nursing-home bed, home visits from an aide, or the Medicare premiums they cannot pay on their own.
- Six in ten North Carolina nursing-home residents depend on Medicaid to pay for their care. Medicaid is the primary payer for 60% of the people in North Carolina's certified nursing facilities, who numbered 35,329 in KFF's latest count, so the law's Medicaid cuts land directly on the homes' budgets, while the staffing standard that would have required more caregivers per resident stays on hold for nearly a decade.
- 22,300 North Carolinians are already waiting for Medicaid home care. KFF counts 22,300 people waiting in 2026 for a slot in North Carolina's Medicaid home and community-based care programs, which deliver care in people's own homes. The Bipartisan Policy Center finds optional services like these more exposed to cuts when budgets tighten.
- Hospital assessments that pay North Carolina home-care workers face cuts. North Carolina's hospital assessments put $140 million toward wages for workers who deliver home and community-based services, and with the law capping those assessments, that money and other programs they fund "may be in jeopardy of facing reductions or being eliminated entirely over time," the North Carolina Medical Journal reported.
Frequently Asked Questions About Richard Hudson on Elder care
What is Richard Hudson's record on elder care under Trump?
Richard Hudson's 2025 votes took the One Big Beautiful Bill Act from budget plan to law: a deciding yes on the February 25 budget resolution, a deciding yes on the May 22 House bill, and a yes on the final law on July 3. The law keeps the nursing-home staffing standard unenforced through 2034, freezes rules that help poor seniors pay Medicare premiums, and takes money from Medicaid, which covers six in ten North Carolina nursing-home residents.
How long does the law Richard Hudson voted for keep nursing-home staffing standards off the books?
Richard Hudson's July 3, 2025 vote went to a law that keeps federal officials from enforcing the 2024 minimum staffing rule until September 30, 2034, leaving the 35,329 people in North Carolina nursing homes most of a decade before the 2024 staffing rule can be enforced. KFF says the delay saves Medicaid $23 billion, and Consumer Voice estimated the rule would have saved 13,000 lives a year.
When will North Carolina home care feel the provider-tax limits Richard Hudson voted for?
Starting October 1, 2027, when the law Richard Hudson voted for begins lowering the provider-tax ceiling a half point a year until it reaches 3.5% in 2031, the North Carolina Medical Journal reported. North Carolina's hospital assessments now put $140 million toward wages for home-care workers, one of the programs the journal said could shrink or disappear as the cap tightens.
Last updated: 2026-10-27