Voters in nursing homes already face unique difficulties. New CMS guidance may make voting in a nursing home even harder.Chris Urso/Tampa Bay Times/Zuma
The Centers for Medicare and Medicaid Services, under Trump appointee Mehmet Oz, changed their guidance on voting in nursing homes last month. Now, a group of senators is saying that these changes are designed to disenfranchise America’s two million nursing home residents.
“On July 20, 2026, CMS issued a memo that appears to be an attempt to intimidate nursing home staff from assisting residents in the voting process,” a group of senators led by Elizabeth Warren (D-Ma.) and Alex Padilla (D-NJ) wrote August 12, in a letter addressed to Oz and shared exclusively with Mother Jones. The new memo “replaces language from CMS’s 2020 and 2024 guidance aimed at ensuring that facilities helped residents to vote with language threatening nursing home staff with prosecution for voter fraud.” The new guidance removes suggestions of specific ways nursing home staff can help residents vote—providing transportation to polling places, for example—and instead threatens staff with fraud investigations if they “engage in inappropriate coercion or other violations of residents’ rights.”
The new CMS memo is the latest in a series of Trump administration actions designed “to restrict vote by mail and undermine the right to vote based on unfounded allegations of voter fraud tied to the President’s denial of prior valid election results,” the Senators wrote.
According to CMS officials, there is a legitimate voter fraud threat in nursing homes. “Unfortunately, in recent years, we have become aware of several allegations of instances in which resident rights were unlawfully violated,” the July CMS memo says. But the instances they mention did not lead to any actual fraudulent voting. The memo cites two specific examples of supposed voter fraud in nursing homes in Texas and Wisconsin. But in the Texas case, no improper votes were ever cast, though a nursing home clerk was charged with criminal voter fraud for making technical errors in the voter registration system. And in the Wisconsin case, a sheriff’s claim of coerced voting at a nursing home was later thrown out.
Nursing home residents face unique barriers to voting. Many lack their own transportation, contend with polling places that are not ADA compliant, or may require assistance to fill out their ballots.
The new guidance might encourage staff to avoid helping residents vote. Many nursing home staff in the United States are immigrants who have already been targeted by Trump’s rollback of programs like TPS. “The removal of guidance on vote by mail procedures, combined with specific threats to investigate nursing home staff for assisting residents who are exercising their right to vote, may deter nursing homes from assisting residents with voting by mail,” the senators wrote. CMS spokespeople did not immediately respond to a request for comment.
