In 2025 Roger Marshall 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 most residents of Kansas nursing homes.
Marshall voted to confirm Mehmet Oz, whose agency in December 2025 repealed the nursing home minimum staffing standards, and in July 2026 he voted against taking up a resolution to end Medicare's new prior-authorization pilot. On the Senate floor, Marshall said Republicans would "make sure that your seniors in nursing homes" have Medicaid in the future.
Roger Marshall's Votes and Statements on Nursing Homes, Home Care and Medicare
- Marshall Cast a Deciding Vote for the Medicaid Cuts and a Ban on the Nursing-Home Staffing Standard, in July 2025. On July 1, 2025, Roger Marshall 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.
- Marshall Voted Against a Rule Protecting Seniors in Nursing Homes From Medicaid Cuts in February 2025. On February 20, 2025, Marshall 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.
- Marshall Voted Against Removing Provisions That Would Close Nursing Homes, in June 2025. On June 30, 2025, Marshall voted no on Senator Jack Reed's motion to send H.R. 1 back to committee with changes that "would eliminate any provisions that would lead to any nursing home closures" and any that change state provider taxes. It failed 48 to 52. Provider taxes on nursing facilities, which are in place in 46 states, are among the financing sources the law's moratorium freezes.
- Marshall Spoke and Voted Against Striking the Medicaid Cuts That Pay for Home Care, in June 2025. On June 30, 2025, Marshall urged senators to vote no on Senator Ron Wyden's motion with instructions that "would strike any provision that cuts funding for Medicaid," and then voted no. Every Republican voted no, and 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.
- Marshall Cast the Vote That Defeated a Protection for Family Caregivers in April 2025. On April 4, 2025, Marshall 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 alone would have changed the result. 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.
- Marshall Voted to Confirm Mehmet Oz, Whose Agency Repealed the Nursing-Home Staffing Standard, in April 2025. On April 3, 2025, Marshall 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.
- Marshall Voted to Keep Medicare's Prior-Authorization Pilot in July 2026. On July 16, 2026, Marshall 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.
- Marshall Voted to Confirm Lori Chavez-DeRemer, Whose Department Held Back Senior Jobs Money for Months in 2025. On March 10, 2025, Marshall voted to confirm Lori Chavez-DeRemer as secretary of labor. In summer 2025 her department withheld the roughly $300 million set aside for national grant recipients of the Senior Community Service Employment Program, which places low-income people 55 and older in paid community jobs; one national grantee furloughed 800 low-income senior participants due to the funding gap. The hold was transient: on September 30, 2025, the Labor Department issued guidance that "allots the full year grant period for National Grantees totaling $307,072,086."
- Marshall Promised Seniors in Nursing Homes Would Keep Medicaid, Then Voted Against Removing Provisions That Would Close Nursing Homes. On June 30, 2025, Marshall told the Senate: "We are going to make sure that your seniors in nursing homes, that pregnant women, children, and people with disabilities have Medicaid in the future." The same day he voted against the Reed motion to remove provisions that would lead to nursing home closures, and the law he then voted for cuts federal Medicaid funding for Kansas by about $3.35 billion over ten years, by KFF's allocation of the Congressional Budget Office estimate.
What Roger Marshall's Votes Mean for Older Kansans
- Nursing homes. Medicaid is the primary payer for 60 percent of residents of Kansas's certified nursing facilities, where 15,033 people lived in KFF's most recent count.
- Home care. 6,792 Kansans were already waiting for Medicaid home care in 2026, before the law's cuts phase in.
Frequently Asked Questions About Roger Marshall on Elder care
What is Roger Marshall's record on elder care under Trump?
Roger Marshall 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. Marshall also voted to confirm Mehmet Oz, whose agency repealed the staffing standards, and voted to keep Medicare's WISeR prior-authorization pilot.
Did Roger Marshall vote to end the nursing-home staffing rule?
Yes. Roger Marshall voted for the One Big Beautiful Bill Act, whose section 71111 bars enforcement of the 2024 nursing-home staffing rule through September 30, 2034. 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.
Will the law Roger Marshall voted for cut home care for seniors in Kansas?
The law Roger Marshall voted for cuts federal Medicaid by an estimated $911 billion over 10 years, and home care relies on optional Medicaid authorities that are vulnerable to state budget pressures, the Bipartisan Policy Center says. Many of the cuts phase in after 2026, and Kansas already had thousands of people waiting for Medicaid home care before they take effect.
Last updated: 2026-10-25