Healthcare
John Cornyn (R)
Cornyn voted for every major ACA repeal-and-replace attempt — the 2017 skinny repeal, the BCRA, and Graham-Cassidy — and opposes extending the enhanced premium tax credits that expire in 2025. He supports Health Savings Account expansion, association health plans for small businesses, and Medicaid block grants to states. He voted for the Inflation Reduction Act's $35 Medicare insulin cap but against the broader prescription-drug-price-negotiation framework, calling it price controls. He has championed mental-health-parity enforcement, the 988 Suicide and Crisis Lifeline, and rural-hospital relief legislation that targets the closures hitting Texas hardest. He has consistently voted against any public-option framework.
Ken Paxton (R)
Paxton has 'gone after the ACA in court numerous times and has long opposed the law,' per Tribune reporting. He has not publicly addressed the 2025 expiration of the ACA enhanced premium tax credits, projected to drop hundreds of thousands of Texans from coverage. He has vigorously defended Texas's near-total abortion ban with its fertilization-onward fetal personhood definition and has not commented on Trump's IVF accessibility plan. He sued the Biden administration in 2024 to block CMS nursing-home minimum staffing rules, arguing they would force rural facilities to close. In Sept. 2025 he won a federal ruling striking down a CMS rule that would have expanded federal oversight of state Medicaid funding mechanisms.
Sources
- Sen. John Cornyn, official Senate website and 2026 re-election campaign issues page, accessed May 2026 (cornyn.senate.gov; johncornyn.com). (full list)
- Gabby Birenbaum, 'On the issues: A Q&A with Ken Paxton and John Cornyn,' Texas Tribune, April 20, 2026. (full list)
- Texas Attorney General, 'Sues Biden Administration Over Rule That Could Force Rural Nursing Homes to Shut Down,' Aug. 2024. (full list)
- Texas Attorney General, 'Secures Victory Protecting the Integrity of States' Medicaid Programs,' Sept. 2025. (full list)
- Cornyn votes on ACA repeal-and-replace (2017 skinny repeal, BCRA, Graham-Cassidy); Cornyn as co-sponsor of Health Savings Account expansion; statements on Medicare/Medicaid block grants; opposition to enhanced premium tax credit extension (2025). (full list)