¶ Overview
Miller-Meeks betrayed Iowans and her former patients by voting for a bill that is estimated to kick 17 million Americans off their health insurance, including nearly 12 million Americans who rely on Medicaid. An estimated 24,696 Iowans could lose their health insurance as a result of her vote.
Miller-Meeks has spent a decade railing against the Affordable Care Act (ACA) and claimed she ran for congress because of its “failures.” The drop in Iowans who were uninsured was largely attributed to the expansion of public insurance plans and the ACA. An estimated 136,000 Iowans were enrolled in ACA marketplace health insurance plans.
¶ Miller-Meeks, Who Has A History Of Voting To Cut Medicaid, Voted In 2025 To Gut Medicaid And Kick 12 Million Americans Off Their Health Coverage
¶ 2025: Miller-Meeks Voted Three Times to Take Health Coverage Away from Iowans
¶ July 2025: Miller-Meeks Voted For The Final Version Of The Republican Reconciliation Bill
July 2025: Miller-Meeks Voted For The Senate FY 2025 Budget Reconciliation Bill That Extended $4 Trillion In Expiring Tax Cuts, Added New Tax Breaks, Appropriated $448 Billion In Defense, Border, And Immigration Enforcement Funding, Increased The SALT Deduction To $40,000, And Cut Medicaid And Other Social Programs To Offset The Costs. In July 2025, Miller-Meeks voted for, according to Congressional Quarterly, the “motion to concur in the Senate amendment to the bill that would permanently extend nearly $4 trillion in expiring individual and business tax cuts, create several new tax breaks and fund border and immigration enforcement and air traffic control upgrades. It would cut Medicaid and other safety net programs to partly offset the cost. Among other provisions, it would raise the statutory debt ceiling by $5 trillion and appropriate more than $448 billion in mandatory funding for Trump administration priorities and other needs, including $153 billion for defense, $89 billion for immigration enforcement, and $89.5 billion for border control and security. It also would increase the state and local tax deduction cap to $40,000 annually for five years for households making up to $500,000 a year until 2030, when it would permanently revert to $10,000.” The House passed the bill by a vote of 218 to 214. [House Vote 190, 7/3/25; Congressional Quarterly, 7/3/25; Congressional Actions, H.R. 1]
- HEADLINE: "At Least 17 Million Americans Would Lose Insurance Under Trump Plan" [Washington Post, 7/1/25]
- The Congressional Budget Office Estimated That 11.8 Million People Would Become Uninsured As A Result Of The Medicaid Cuts In Republicans’ Reconciliation Bill. According to the Washington Post, "The bill, which narrowly passed the Senate on Tuesday and now heads back to the House, would effectively accomplish what Republicans have long failed to do: unwind many of the key components of the ACA, President Barack Obama’s signature domestic achievement, which dramatically increased the number of Americans with access to health insurance. To start, the Congressional Budget Office estimated that the Senate version of the bill would result in 11.8 million more uninsured in 2034, mostly because of Medicaid cuts, compared with 10.9 million if the House version became law." [Washington Post, 7/1/25]
¶ May 2025: Miller-Meeks Voted In Favor Of House Republicans’ Reconciliation Bill, Which Cut Medicaid
May 2025: Miller-Meeks Voted For The FY 2025 Budget Reconciliation Bill That Included $3.8 Trillion In Tax Cuts Offset By $1.5 Trillion In Spending Reductions To Programs Like Medicaid And The Supplemental Nutrition Assistance Program. In May 2025, Miller-Meeks voted for, according to Congressional Quarterly, “the bill that would provide for approximately $3.8 trillion in net tax cuts and $321 billion in military, border enforcement and judiciary spending, offset by $1.5 trillion in spending reductions, as instructed in the fiscal 2025 budget resolution (H Con Res 14). It would raise the statutory debt limit by $4 trillion and provide for increased spending on defense and border security, spending cuts on social safety net programs, such as Medicaid and the Supplemental Nutrition Assistance Program. It also includes a mix of tax breaks for businesses and individuals; tax increases on universities and foundations; and a phase-down of clean energy tax credits. […] It would reduce federal spending on the Supplemental Nutrition Assistance Program by requiring states to shoulder more of the cost, expand work requirements for SNAP, extend programs authorized under the 2018 farm bill, and prohibit the U.S. Department of Agriculture from increasing the cost of the Thrifty Food Program. As amended, it would cap state and local tax deductions at $40,000 for households with incomes below $500,000.” The House passed the bill by a vote of 215 to 214. [House Vote 145, 5/22/25; Congressional Quarterly, 5/22/25; Congressional Actions, H.R. 1]
- The House GOP Budget Bill Was Estimated To Increase The Uninsured Population By 8.6 Million By 2034. According to CNN, “The Medicaid and Affordable Care Act provisions in the package could result in 8.6 million more people being uninsured in 2034, according to an early CBO estimate released by Democratic lawmakers. That number is expected to grow with the latest changes.” [CNN, 5/28/25]
- HEADLINE: “House Republican Budget Takes Away Health Care, Food Aid To Pay For Expanded Tax Cuts For Wealthy” [Center on Budget and Policy Priorities, 2/21/25]
- HEADLINE: “CBO: 7.6 Million Would Go Uninsured Under GOP Medicaid Bill” [Politico, 5/13/25]
¶ February 2025: Miller-Meeks Voted For House Republicans’ Budget Framework, Which Set Up Future Cuts To Medicaid
February 2025: Miller-Meeks Voted For The FY 2025 Budget Framework That Included $2 Trillion In Cuts, Raised The Statutory Debt Limit By $4 Trillion, And Required House Committees To Recommend Legislation That Would Implement Trump’s Agenda. In February 2025, Miller-Meeks voted for, according to Congressional Quarterly, “the concurrent resolution that would recommend a budget for fiscal 2025 and budget levels through fiscal 2034. The resolution would assume minimum savings of $1.5 trillion over 10 years and 2.6 percent economic growth over the same period. It also would require the statutory debt limit to be raised by $4 trillion. It also would authorize the House Ways and Means Committee to increase deficits by $4.5 trillion over 10 years to extend the 2017 tax cuts and implement new tax cuts proposed by the White House. It also would provide instructions for the budget reconciliation process through which separate legislation could be considered and passed in the Senate via a simple majority vote. The measure would deliver instructions to 11 House committees to report legislation that would implement President Donald Trump’s agenda, such as expanding tax cuts and bolstering border security and immigration enforcement. The committees would be required to report their legislative recommendations to the House Budget Committee by March 27, 2025. It also would set a $2 trillion target for the spending cuts to be submitted to the House Budget Committee. The resolution also would stipulate that if the committees don't reach that target, the Ways and Means’ reconciliation instructions to increase the deficit by a maximum of $4.5 trillion would be decreased by the amount the other committees come in below the target. Similarly, it would stipulate that Ways and Means could increase the deficit above the $4.5 trillion level by the amount of savings the committees achieve above the $2 trillion target.” The vote was on passage. The House passed the resolution by a vote of 217 to 215. [House Vote 50, 2/25/25; Congressional Quarterly, 2/25/25; Congressional Actions, H. Con. Res. 14]
- HEADLINE: "House Republican Budget Takes Away Health Care, Food Aid To Pay For Expanded Tax Cuts For Wealthy" [Center on Budget and Policy Priorities, 2/21/25]
- New York Times Reported The $880 Billion In Cuts Required By The Republican Budget Proposal Would Have To Come From Medicaid, Medicare, Or CHIP. According to the New York Times, "The budget resolution itself is silent on whether Congress cuts Medicaid, which provides health coverage to 72 million poor and disabled Americans. But it instructs the House Energy and Commerce Committee, which has jurisdiction over the program, to cut spending by $880 billion over the next decade. If the committee can’t save at least that much, the entire effort could be imperiled because of the special process Congress is using to avoid a Senate filibuster. Ten other committees have their own instructions to follow, though none have been assigned with cutting nearly as much. It’s not so simple as finding the cuts elsewhere. The special process, known as budget reconciliation, means Republicans will have to find all $880 billion from within the Energy and Commerce Committee’s jurisdiction. That leaves them with fewer options than one might think. […] If Republicans want to avoid major cuts to Medicaid, the largest pot of available money is in the other big government health insurance program: Medicare. […] Even if the committee cuts everything that’s not health care to $0, it will still be more than $600 billion short. The committee could also save around $200 billion by eliminating the Children’s Health Insurance Program, but that option has not been raised by the budget committee or anyone in House leadership. […] Even if all of these cuts, revenues and rule cancellations from outside health care can pass muster, the committee will still be left with hundreds of billions of dollars to cut to hit its goal. Mathematically, the budget committee’s instructions mean the committee would need to make major cuts to either Medicare, Medicaid or both." [New York Times, 2/25/25]
- February 2025: Miller-Meeks Voted In Favor Of The GOP Budget Package That Spelled Out Future Medicaid Cuts. According to Radio Iowa, "The four Republicans who represent Iowa in the U.S. House have voted for the GOP budget plan that includes an extension of tax cuts President Trump approved in 2017. […] About 100 people gathered outside Congresswoman Mariannette Miller-Meeks office in Davenport earlier today to protest the proposed cuts in Medicaid." [Radio Iowa, 2/25/25]
¶ Miller-Meeks Defended Her Votes To Cut Medicaid As A “Once-In-A-Generation Victory” And Claimed She Voted In The Interest Of Her Constituents
July 2025: Miller-Meeks Defended The Republican Reconciliation Bill As A “Once-In-A-Generation Victory For The American People” And She Was “Proud” To Have Voted For It. According to a press release from Rep. Mariannette Miller-Meeks’ office, "Statement from Rep. Miller-Meeks on the Passage of H.R.1: ‘Today, the House delivered on the mandate given to us by 77 million Americans and passed President Trump’s One Big Beautiful Bill. This legislation prevents the largest tax hike on Iowa families and small businesses in history by making the Tax Cuts and Jobs Act permanent. It reduces taxes on tips and overtime, doubles the child tax credit, provides a $6,000 tax break for seniors, brings manufacturing jobs back to America, and restores our energy dominance. After four years of crushing inflation and high energy costs under Joe Biden, this bill delivers the relief hardworking Americans deserve. It also secures the border for good by ending catch-and-release, finishing the fence, and hiring thousands of new agents with the tools to stop crime, fentanyl, and chaos. This bill strengthens and preserves Medicaid for those it was intended to serve: children, pregnant women, seniors, veterans, and people with disabilities. It also delivers $50 billion in new relief for rural hospitals serving communities like ours. This is a once-in-a-generation victory for the American people. I was proud to vote for it and look forward to President Trump signing it into law just in time for Independence Day.’” [Press Release – Rep. Mariannette Miller-Meeks, 7/3/25; H.R. 1, House Vote 190, 7/3/25]
Miller-Meeks Claimed The GOP Reconciliation Bill Brought “Common Sense Back To Medicaid.” According to a post on Rep. Mariannette Miller-Meeks’ Twitter, “The American people are tired of watching their tax dollars fund a broken system. The One Big Beautiful Bill brings common sense back to Medicaid by ending benefits for illegal immigrants and adding work requirements for able bodied adults who can work, but choose not to.” [Twitter, @RepMMM, 6/24/25] (video)
Miller-Meeks Claimed She Was Voting In Her Constituents Best Interests When Supporting Trump’s “Big Beautiful Bill.” According to Our Quad Cities, "‘When you are in Congress, you are supposed to be the voice of the people that put you there, and they deserve to have answers on what you are doing,’ said Travis Terrell, a Democratic candidate for Rep. Miller-Meeks’ 1st Congressional District seat. Rep. Miller-Meeks, though, feels as if she is doing just that. ‘We are absolutely voting in (the constituents’) best interest because we voted to preserve and strengthen Medicaid,’ Miller-Meeks said. ‘Had we not done that, the trajectory of Medicaid spending is unsustainable.’" [Our Quad Cities, 5/29/25]
- HEADLINE: “Congress Passes Budget Bill With Deep Cuts To Medicaid And SNAP. What That Means For Iowa” [Des Moines Register, 5/22/25]
- HEADLINE: “Protesters Wait Outside Rep. Miller-Meeks’ Event In Davenport” [Our Quad Cities, 5/29/25]
February 2025: Miller-Meeks Claimed The House Republican Budget Resolution Was The First Step Toward Lowering Costs. According to a post on Rep. Mariannette Miller-Meeks’ Twitter, "I voted to advance a budget resolution to ensure that Iowans do not see their paychecks shrink. If Democrats stand in the way, almost every Iowan would see a tax HIKE. Small businesses and farmers could see a 20% tax increase and families would see the child tax credit cut in half. This is the first step for @POTUS America First Agenda of lowering costs, American energy dominance and securing our border." [Twitter, @RepMMM, 2/25/25]
¶ 2025: Miller-Meeks Served As A Member Of The House Energy And Commerce Committee, Which Was Tasked With Making Medicaid Cuts
During The 119th Congress, Miller-Meeks Served On The House Energy And Commerce Committee. According to a press release from Rep. Mariannette Miller-Meeks, "‘I’m honored to have been chosen to serve on the House Committee on Energy and Commerce,’ said Representative Miller-Meeks. ‘I’m proud of my background as a surgeon, and I’m confident that experience, paired with Iowa’s leadership in the clean energy space, leaves me uniquely qualified for this role. I look forward to working with Chair Rodgers, and I’m excited for the opportunity to represent Iowa on the committee.’" [Press Release – Rep. Mariannette Miller-Meeks, 1/11/25]
¶ Miller-Meeks Has Voted to Kick Iowans Off Medicaid in The Past as Well
¶ 2023: Miller-Meeks Voted For A GOP Package That Would Have Kicked Two Million Americans Off Their Health Insurance
2023: Miller-Meeks Voted For A GOP Debt Limit Package, Which Would Expand Or Create Work Requirements For Medicaid Recipients Of The Ages Between 19 And 55. In April 2023, according to Congressional Quarterly, Miller-Meeks voted for the Limit, Save, Grow Act of 2023, which would “expand or establish work requirements for Medicaid beneficiaries aged 19 to 55.” The vote was on passage. The House passed the bill by a vote of 217 to 215, thus the bill was sent to the Senate. [House Vote 199, 4/26/23; Congressional Quarterly, 4/26/23; Congressional Actions, H.R. 2811]
- The Congressional Budget Office Found That The Provisions Over Medicaid Work Requirements Would Have A “Negligible Effect” On Getting Individuals Back To Work And Would Make States Pay For Medicaid Coverage For About 900K People Who Would Lose Access To Federal Fund Access. According to Congressional Quarterly, “In response to an inquiry from House Energy and Commerce ranking member Frank Pallone Jr., D-N.J., the CBO looked at potential impacts of the measure’s new Medicaid work requirements. The agency found that the rules would have a ‘negligible effect’ on getting people back into the workforce or boosting hours worked. The CBO also found that states which pick up the tab for Medicaid coverage for about 900,000 individuals who’d lose access to federal funds under the provision would have to pony up about $65 billion extra through fiscal 2033. For roughly 600,000 people that would lose coverage, states would save about $5 billion.” [Congressional Quarterly, 4/27/23]
- The Medicaid Work Requirement In House Republicans’ Default On America Act Could Have Resulted In Almost Two Million Americans Being Unenrolled In Medicaid And Shifted Some Costs To The States. According to KFF, "On April 26, 2023, the House of Representatives passed a Republican debt ceiling bill (HR 2811, the Limit, Save, Grow Act of 2023) that includes a requirement for states to implement work requirements for certain Medicaid enrollees. Data show that 91% of non-elderly Medicaid enrollees who are not on Supplemental Security Income or Medicare are working or face barriers to work. We estimate that if the proposal were fully implemented in 2024 and the rate of Medicaid eligibility loss was as the Congressional Budget Office (CBO) estimated, then 1.7 million enrollees would not meet work or reporting requirements and potentially face disenrollment in that year. States could continue to provide Medicaid to those enrollees but would not receive federal matching funds for doing so. It is unclear if any states would choose to do that, though CBO estimated over half of enrollees would continue to be covered at the states’ expense. If states chose to keep all 1.7 million people enrolled, $10.3 billion of Medicaid spending would shift from the federal to state governments in 2024. A small number of states with the largest share of enrollees under the Affordable Care Act (ACA) Medicaid expansion would account for almost half of the increased state spending or coverage losses." [KFF, 5/5/23]
¶ 2020: Miller-Meeks Voted To Threaten 71,000 Iowans’ Medicaid Benefits
March 2020: Miller-Meeks Voted For Work Requirements For Iowans On Medicaid. According to the Iowa Starting Line, “State Sen. Mariannette Miller-Meeks joined 30 of her Republican colleagues this week to vote in favor of legislation requiring certain Iowa Medicaid recipients to work, volunteer or participate in a job training program in order to receive their health care benefits. Senate File 2366 passed the GOP-controlled Senate 31-18. No Democrats voted in favor of the bill.” [Iowa Starting Line, 3/6/20]
- 3/3/20: Miller-Meeks Voted For Senate File 2366, Which Would Institute Work Requirements For Public Assistance Programs, Including Medicaid And SNAP. In March 2020, according to the Iowa State Legislature, Mariannette Miller-Meeks voted for “Senate File 2366.” The bill passed the Iowa Senate 31-18, and ultimately died in the Iowa House. [Iowa State Legislature, SF 2366 (2020), Introduced 2/20/20; Iowa Senate Vote S.J. 494, 3/3/20]
- The Bill Would Have Required Medicaid Beneficiaries To Work, Volunteer, Or Participate In A Work Program For An Average Of 20 Hours Per Week To Qualify For Medicaid Benefits. According to the Des Moines Register, "Able-bodied Medicaid recipients would have to work, volunteer or participate in a work program for an average of 20 hours per week, or meet the requirements of a workfare program, under this bill. The bill would also broaden work requirements for food stamps by preventing the Department of Human Services from applying for any federal work requirement waivers, and by assigning some food stamp recipients to an employment and training program. Senate File 2366.” [Des Moines Register, 2/22/20]
The Legislative Services Agency Of Iowa Found That Approximately 71,000 Iowans’ Benefits Could Be In Question Following The Passage Of Work Requirements. According to the Des Moines Register, "The exact number of non-working recipients who would be required to find work or volunteer under the bill is unclear. Last year, a report from the nonpartisan Legislative Services Agency on a similar bill found that out of approximately 167,000 Iowans on the Iowa Health and Wellness Plan, 57.5% of members would be exempt from the work requirements, leaving nearly 71,000 members whose cases would need to be reviewed." [Des Moines Register, 3/3/20]
¶ An Estimated 146,000 Iowans in The First Congressional District Relied on Medicaid or Chip for Health Insurance
146,000 Iowans In The 1st Congressional District Were Enrolled In Medicaid Or CHIP. According to the Center for American Progress,
[Center for American Progress, 3/11/25]
¶ Miller-Meeks Has Spent A Decade Railing Against The Affordable Care Act (ACA) And Claimed It’s What Lead Her To Run For Congress
¶ Miller-Meeks Said She Ran for Congress Over the “failures of The Affordable Care Act”
2023: Miller-Meeks Claimed She Was Motivated To Run For Congress Over The “Failures Of The Affordable Care Act.” According to an interview with Mariannette Miller-Meeks by the American Medical Association, "Question: How did you become interested in serving in the U.S. House of Representatives? MILLER-MEEKS: My interest in serving in Congress stemmed from my experiences in the military and in the medical field. Specifically, I first decided to run for office when I witnessed, first-hand, the failures of the Affordable Care Act. Patients couldn’t pay their premiums or control their care. As a physician, I know that financial burdens and stressors not only impact a person’s livelihood, but also change a person’s overall mental and physical well-being. So, I had to stand up and speak out against what I viewed as a deliberate injustice to patients, and I thought the best way to go about making a meaningful change was running for office." [American Medical Association, 11/17/23]
¶ 2020: Miller-Meeks, Who Supported Repealing The ACA, Said Congress Needed To Prepare For The Law To Be Overturned
2020: Asked About Her Plan To Replace The Affordable Care Act If Repealed, Miller-Meeks Refused To Offer Specifics And Instead Criticized The Law. According to CBS 2 Iowa, "Nick Weig: There was talk for years about repealing and replacing the Affordable Care Act, there was an attempt to repeal it two or three years ago but that obviously failed by one vote in the Senate. What is the Republican plan because we hear about repealing most or all of the Affordable Care Act but what is the actual plan to replace it? Mariannette Miller-Meeks: Well I think that there are various ideas and various plans that have come about and I know that Congresspeople, Republican Congresspeople in the Doctor's Caucus have discussed that and have a plan, but if you remember the ACA was supposed to not only increase the number of people with medical insurance, but it was also supposed to bring down costs. And I think that the Washington Post even gave that four pinnochios in that one of the greatest lies of that time that premiums would go down by $2500 so here we are in a system which the ACA was supposed to solve all these problems, but we still don't have portability of medical insurance." [CBS 2 Iowa, 10/13/20]
2020: Miller-Meeks, Who Supported Repealing The ACA, Claimed Both Parties Needed To Prepare For The ACA To Be Overturned By The Supreme Court. According to the Iowa City Press-Citizen, "Like the Republican colleagues she hopes to join, Miller-Meeks has been on the record about her support for repealing the ACA. During Thursday's debate, she said Congress needs to prepare for replacing it. ‘Given that this is coming to the Supreme Court in the next month, I think Congress needs to — in a bipartisan way — both parties get together and work on what happens should the ACA be overturned. We don't know if it will be, but we need to start working on that provision right now. And make sure people continue to have coverage and preexisting conditions are covered as well,’ Miller-Meeks said." [Iowa City Press-Citizen, 9/25/20]
¶ 2015: Miller-Meeks Claimed The Affordable Care Act Was A “Bad Law”
2015: Miller-Meeks Said The Affordable Care Act Was A “Bad Law” And “Poorly Written.” According to a post on Mariannette Miller-Meeks’ Twitter, “Bad law, poorly written RT @cobrown: Is #ACA a bad law clearly written or a good law poorly written? #KingvBurwell. http://bit.ly/18iT8FV”
[Twitter, @millermeeks, 3/5/15]
¶ 2025: 136,833 Iowans Were Enrolled in The Affordable Care Act
136,833 Iowans Were Enrolled In The Affordable Care Act Marketplace In 2025. According to KFF,
[KFF, Viewed 7/28/25]
- 2022: Iowa’s Uninsured Rate Was Among The Lowest In The United States At 5.4 Percent. According to Axios, "Iowa in 2022 had among the country's lowest shares of residents under 65 without health insurance, according to new Census Bureau data. But newer, preliminary numbers show that might be changing. Why it matters: Uninsured people are more likely to forgo needed care or preventative services, which can lead to higher rates of chronic disease with expensive and disabling complications. State of play: As of 2022, Iowa's 5.4% uninsured rate was tied with Minnesota's, and lower than those of all surrounding states. Only Massachusetts (2.9%), Washington, D.C. (3.1%), Hawaii (4.3%), Vermont (4.9%) and Rhode Island (5.2%) were lower. Catch up quick: Iowa's rates dropped about 10 years ago, mostly attributed to public insurance plans and the expansion of the Affordable Care Act." [Axios, 8/19/24]
- The Drop In Iowa’s Uninsured Rates Was Largely Attributed To Public Insurance Plans And Expansion Of The ACA. According to Axios, "Iowa in 2022 had among the country's lowest shares of residents under 65 without health insurance, according to new Census Bureau data. But newer, preliminary numbers show that might be changing. Why it matters: Uninsured people are more likely to forgo needed care or preventative services, which can lead to higher rates of chronic disease with expensive and disabling complications. State of play: As of 2022, Iowa's 5.4% uninsured rate was tied with Minnesota's, and lower than those of all surrounding states. Only Massachusetts (2.9%), Washington, D.C. (3.1%), Hawaii (4.3%), Vermont (4.9%) and Rhode Island (5.2%) were lower. Catch up quick: Iowa's rates dropped about 10 years ago, mostly attributed to public insurance plans and the expansion of the Affordable Care Act." [Axios, 8/19/24]