How did your KY congressman vote on Trump-backed bill cutting Medicaid spending?
The first major piece of legislation in President Donald Trump’s second term is a sprawling budget bill that would have far-reaching impacts on American life.
Perhaps its most notable feature for Kentuckians: cuts to Medicaid spending, including adding a work requirement effective Dec. 31, 2026. Kentucky, particularly the Eastern Appalachian region, is especially reliant on the government-funded health insurance program.
The latest version of the bill, passed late Wednesday by the U.S. House of Representatives by a slim margin of 215-214 and dubbed the “big, beautiful bill” in Trump parlance, would also extend tax cuts primarily benefitting the top 10% of earners, extend a child tax credit program, increase spending on the military and border security and raise the tax deduction wealthy high-tax state residents can claim.
Four of the five Kentucky Republican House members voted in favor of the bill. Democrat Rep. Morgan McGarvey, of Louisville, voted no, as did Northern Kentucky Rep. Thomas Massise, on the grounds it would increase the rising national debt.
Most experts agree the Medicaid changes, which increase paperwork on both the individual and state level, would result in millions of current Medicaid enrollees coming off the state-funded health insurance program. The Congressional Budget Office estimated that a previous iteration of the bill could lead to 7.6 million people currently on Medicaid going uninsured.
The office estimated the work requirement alone would result in $280 billion in reduced government spending over six years, a figure that is expected to help cover revenue lost in the tax cut extension.
The bill includes changes to how states that don’t expand Medicaid under the Affordable Care Act are treated, too. A new amendment to the bill financially incentivizes states not to expand coverage to people with incomes not below, but still near, the poverty line.
Republican House leadership, including 2nd Congressional District Rep. Brett Guthrie, who chairs the committee in which the Medicaid changes originated, insists the bill combats “waste, fraud, and abuse.”
Scrutiny from Kentucky Democrats and activists alike has centered on Rep. Hal Rogers, whose Eastern and Southern Kentucky district is the most Medicaid-reliant in the state by far and among the most dependent on the program in the country.
Ned Pillersdorf, a Prestonsburg attorney who ran for Congress in the 1990s, called Rogers’ vote “shameful,” particularly when the bill passed by just one vote.
“Rogers issued all these statements that he was against the Medicaid cuts, and he could personally have stopped it. I just think it’s almost an act of treason to the vulnerable people in our area who Rogers claims he cares about,” Pillersdorf said.
Rogers, in a statement, said the bill “secures Medicaid for Eastern Kentuckians living below the poverty line” in its attempt to clean up the rolls.
Rogers defends ‘yes’ vote
In a statement, Rogers highlighted the tax cuts, military spending and other investments in the bill.
But the bulk of it was spent defending the bill’s effect on Medicaid.
“With one of the nation’s highest rates of Medicaid recipients in my congressional district, I did not take this vote lightly. In fact, I voted for the bill because it secures Medicaid for Eastern Kentuckians living below the poverty rate by removing 1.4 million illegal immigrants from the program, along with 1.2 million ineligible recipients,” Rogers wrote.
Of all 435 House districts in the country, Rogers’ district has the 11th-most people on Medicaid. Excluding children covered by Medicaid, it has the most of any district in the country, according to KFF.
Rogers suggested the bill would get almost 5 million able-bodied people without dependents “back to work,” a reference to the requirement that people on Medicaid work at least 80 hours a month.
“Able-bodied individuals ages 19-34 who were added in the Medicaid expansion should not be receiving nine times more than disabled Americans in the traditional program. We must get rid of the waste, fraud and abuse, and it is our duty to secure this program, as well as SNAP benefits, for the American people in greatest need,” Roger said.
Rep. Thomas Massie: One of two GOP ‘no’ votes
In his trademark contrarian debt hawk style, 4th Congressional District Rep. Thomas Massie voted against the bill.
He suggested Congress was partaking in “fantasy math” in supporting the bill while not reckoning with the prospect of raising the national debt.
“I’d love to stand here and tell the American people: ‘We can cut your taxes and we can increase spending and everything is going to be just fine,’ but I can’t do that, because I’m here to deliver a dose of reality.
“This bill dramatically increases deficits in the near term but promises our government will be fiscally responsible five years from now. Where have we heard that before? How do you bind a future Congress to these promises? This bill is a debt bomb ticking.”
The Trump-backed bill has provided the president with an opportunity to reignite an ongoing feud with Massie. He has suggested he would support a primary opponent for Massie and spoke poorly of the Northern Kentucky congressman at a press conference this week.
“I don’t think Thomas Massie understands government,” Trump told reporters. “I think he’s a grandstander, frankly. ... I think he should be voted out of office.”
Andy Barr praises Trump
6th Congressional District Rep. Andy Barr enthusiastically supported the bill.
Barr is running to replace Sen. Mitch McConnell, who is not running for reelection in 2026, and he emphasized Trump’s role in the passage of the bill. The support of Trump, who has not directly weighed in on the race, is seen as a golden ticket to winning the GOP nomination in the contest.
“Make no mistake: This would not have happened without the leadership of the deal maker in Chief President Donald J. Trump,” Barr said on Fox News Thursday morning. “The winners are the people of Kentucky and the people of every state across this country who will now see their taxes reduced, the border secured, Medicaid more efficient, and [the] right size for the people who need it.”
McGarvey amendment denied
Calling the bill “immoral,” McGarvey, Kentucky’s lone Democrat in Congress, voted no.
McGarvey said in a statement he offered an amendment to the bill that would have guaranteed that disabled veterans and children would not lose Medicaid coverage. The amendment was not adopted.
“If you or someone you love relies on a rural hospital, if you have kids in school, if you are someone concerned about our nation’s rising debt, this budget hurts you. This budget disproportionately harms our most vulnerable. By gutting Medicaid and SNAP, Republicans voted to make those on the margins – our children, seniors and those who have the least – poorer, sicker and hungrier,” McGarvey wrote in a statement.
Comer and Guthrie support
Rep. James Comer, whose First Congressional District spans West Kentucky, parts of South-Central Kentucky and a handful of Central Kentucky counties, was a “yes” vote as well.
“The People’s House has delivered on President Trump’s America First agenda. It cuts taxes for hardworking Americans and small businesses — putting more money directly back in your pocket,” Comer said at a press appearance in Washington Thursday.
Rep. Brett Guthrie was one of the key figures in Washington earlier this month as he shepherded a version of the bill through the powerful House Committee on Energy and Commerce.
He echoed Rogers’ comments that the changes made Medicaid “stronger.”
“We strengthened Medicaid, and we delivered on energy dominance,” Guthrie said.
This story was originally published May 22, 2025 at 4:31 PM.
