Roger Marshall voted at least five times against extending the enhanced Affordable Care Act tax credits, including on June 30, 2025 and December 11, 2025, and the credits expired on December 31, 2025. In 2026 the amount enrollees paid in premiums rose sharply, and the average deductible reached a record as people moved to cheaper plans with higher out-of-pocket costs.
Marshall also cast one of the 50 votes that passed the One Big Beautiful Bill Act, which makes enrollees repay excess credits in full starting with tax year 2026 and, from 2028, ends automatic renewal of marketplace coverage. As the House member for Kansas's 1st District, he voted in 2017 for the tax law that ended the insurance mandate penalty. Insurers in Kansas have requested increases of up to 34.81 percent for 2027.
Roger Marshall's Votes on Health Insurance Costs
- Marshall Voted Against Extending the Premium Tax Credits Three Weeks Before They Expired, in December 2025. On December 11, 2025, Roger Marshall voted against advancing S. 3385, which would have kept the enhanced premium tax credits through 2028 by moving their end date to January 1, 2029. It got 51 votes, short of the 60 needed. The credits expired on December 31, and the average benchmark premium before credits had already jumped from $497 per month in 2025 to $625 in 2026.
- Marshall Voted Against Extending the Premium Tax Credits in the One Big Beautiful Bill Act in June 2025. On June 30, 2025, Marshall voted no on an amendment to "extend the enhanced premium tax credits and increase the individual tax rate for taxpayers with income over $10,000,000." All 53 Republican senators voted no. After the credits expired, what enrollees paid in premiums rose 58% on average, from $113 to $178 a month, and average deductibles reached a record $3,786.
- Marshall Voted Against Making the Premium Tax Credits Permanent in Fall 2025. On September 30, 2025, Marshall voted no on S. 2882, a funding bill with a permanent extension of enhanced tax credit, and voted against taking it up again on October 1 and October 9. Two-thirds of the public, 67%, said in January 2026 that Congress did the wrong thing by not extending the credits.
- Marshall Cast a Deciding Vote for Marketplace Changes That Make Enrollees Repay Credits and End Automatic Renewal, in July 2025. On July 1, 2025, Marshall voted for H.R. 1, which passed 50 to 50 with the Vice President breaking the tie. Starting with tax year 2026 it removes the caps on repaying excess advance credits, so a family whose income rises during the year owes the full difference at tax time. From 2028 its new verification rule effectively ends auto-renewals, which the Congressional Budget Office estimates will leave 700,000 more people uninsured.
- Marshall Voted Against Rules Targeting Insurers That Delay or Deny Care and Out-of-Pocket Costs, in April 2026. On April 22, 2026, Marshall voted no on a point of order against budget legislation that fails to address "the practice of insurance companies stepping between patients and their doctors to delay or deny access to care." It failed 49 to 49, short of the 60 votes needed. The same day he voted no on a point of order against budget legislation that "does not lower out-of-pocket health care costs," which failed 48 to 50. The budget resolution then went forward without either protection, as insurers requested a median premium increase of 15% for 2027.
- Marshall Voted to Keep the Administration's Marketplace Paperwork Rule in January 2026. On January 13, 2026, Marshall voted against taking up S.J.Res. 84 to overturn the Centers for Medicare & Medicaid Services' marketplace rule, which added stricter enrollment and eligibility procedures, including additional verification of income. The agency estimated it would add between 725,000 and 1.8 million uninsured people in 2026; many of its requirements are on hold due to pending litigation.
- Marshall Voted Against Preserving the Premium Tax Credits in February 2025. On February 21, 2025, Marshall voted no on an amendment for a reserve fund "preserving and extending" the enhanced premium tax credits. It failed 48 to 52. It was the first of the votes on the credits, which went on to expire at the end of 2025.
- Marshall Voted Against Keeping a $35 Insulin Cap for People With Private Insurance in August 2022. On August 7, 2022, Roger Marshall voted against a motion to keep a $35 monthly insulin cap for people with private insurance in the Inflation Reduction Act. The motion to waive the budget rules failed 57 to 43, three votes short of what was needed, and the cap was removed from the bill. Nearly four years later, people with private insurance still had no federal cap: in July 2026 the Senate was considering a bill that would cap the cost of insulin at $35 per month for people on private insurance.
- Marshall Voted to Confirm Mehmet Oz, Whose Agency Tightened Marketplace Enrollment and Promotes Short-Term Plans, in April 2025. On April 3, 2025, Marshall voted to confirm Mehmet Oz to run the Centers for Medicare & Medicaid Services. His agency is working to make it easier to enroll in short-term plans that, unlike marketplace insurance, can reject consumers based on their medical history.
- As a House Member, Marshall Voted for the 2017 Tax Law That Ended the Insurance Mandate Penalty. On December 20, 2017, as the House member for Kansas's 1st District, Marshall voted for the final version of the Tax Cuts and Jobs Act, whose section 11081 set the Affordable Care Act's individual mandate penalty to zero. The Congressional Budget Office estimated that repealing the mandate meant average premiums would be 10 percent higher in most years in the individual market, with 13 million fewer people having insurance coverage by 2027.
What Roger Marshall's Votes Mean for Health Insurance in Kansas
- Coverage dropped. Kansas's effectuated marketplace enrollment fell 20 percent, from 179,920 in 2025 to 143,880 in 2026, after the enhanced credits expired.
- 2027 requests. Kansas insurers have requested 2027 rate changes including 15.38 percent (Blue Cross and Blue Shield of Kansas City) and 34.81 percent (UnitedHealthcare Insurance Company); these are requests, and final rates may differ.
Frequently Asked Questions About Roger Marshall on Insurance costs
What is Roger Marshall's record on health insurance costs under Trump?
Roger Marshall voted against extending the enhanced Affordable Care Act premium tax credits in June, September and December 2025, and the credits expired at the end of 2025. Marshall also voted for the One Big Beautiful Bill Act, which ends automatic renewal of marketplace plans from 2028, and Kansas's marketplace enrollment fell by a fifth in 2026.
Why did health insurance premiums go up for Kansans in the marketplace, and how did Roger Marshall vote?
Roger Marshall voted against extending the enhanced premium tax credits, and when they expired, enrollees lost help paying premiums. Insurers say the loss of healthier enrollees is pushing 2027 rates up again: Peterson-KFF analysts cite the expiration of enhanced premium tax credits at the end of 2025 and a related increase in the risk pool's morbidity.
How did Roger Marshall vote on the individual mandate?
Roger Marshall voted in December 2017, as a House member from Kansas, for the Tax Cuts and Jobs Act, which set the Affordable Care Act's individual mandate penalty to zero starting in 2019. The Congressional Budget Office had estimated that repeal would leave 13 million fewer people with insurance by 2027.
Last updated: 2026-10-25