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Issue record

Health care

In short

Paige Cognetti's campaign would stop insurance middlemen denying prescribed care and drugs, and reform insurance so people stay covered. Rob Bresnahan's campaign opposes raising the retirement age or cutting Social Security or Medicare, and says he told House leaders he would not back Medicaid cuts for vulnerable people. He voted for the 2025 law adding Medicaid work rules for some adults and less back-dated coverage for others; whether that cuts vulnerable people's coverage is unsettled.

Campaign positions

What each campaign says.

Paige Cognetti

Would stop insurance middlemen from denying care and drugs that doctors prescribe, and reform insurance so people are covered when something happens.

Rob Bresnahan Jr

Will not support raising the retirement age or cutting Social Security or Medicare benefits. In 2025 he told House leaders he would not back a bill that cut Medicaid coverage for vulnerable people, and said the House bill he voted for in May 2025 protects them.

Evidence timeline

What the record shows.

  1. campaign position

    Rob Bresnahan Jr: record does not settle this

    He backed work rules and six-month checks for some adults, plus shorter back-dated coverage for the letter's vulnerable groups. CBO gives no uninsured count for those groups.

    Read the full check

    Full detail

    In April 2025 he and 11 other Republicans told House leaders they would not back a final bill that reduced Medicaid coverage for vulnerable people. He voted for H.R. 1 on May 22, 2025 and for the final version on July 3, 2025. The law requires states to set Medicaid work requirements for certain adults, with exemptions for groups such as people under 19, parents of children 13 and under, and people who are blind or disabled (section 71119). It also requires eligibility checks every six months for expansion adults (section 71107) and lowers the cap on state provider taxes (section 71115). For enrollees outside the expansion group, including children, older and disabled people and pregnant women, it shortens back-dated coverage from three months before applying to two (section 71112), and it pauses two rules meant to ease enrollment until 2034 (sections 71101 and 71102). Why there is no verdict: The letter names children, seniors, people with disabilities and pregnant women as the people Medicaid is meant to help. The law largely leaves these groups out of its work requirements, but shortens their back-dated coverage (section 71112). Whether that is a cut in coverage, and how many people lose coverage, the record does not settle. Limit: In May 2025 his office said he blocked cuts to the provider-tax limit and the expansion match rate. The final law lowers the provider-tax limit but keeps the 90 per cent match, except for emergency care for some non-citizens (section 71110). CBO estimates the law's Medicaid changes leave 7.5 million more people uninsured in 2034, and gives no count for the groups the letter names.

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Sources8 source records

How we use sources

  1. Prioritieshttps://paigeforpa.com/priorities/

    Paige For PA · Reviewed Oct 1, 2026

    Platform: reform, family costs, unions, manufacturing, tariffs, data centers.

    candidate statement

    For: Paige Cognetti: campaign position

  2. Rob for PAhttps://robforpa.com/

    Rob for PA · Reviewed Oct 1, 2026

    Campaign home page, paid for by Rob for PA, the committee's FEC-filed website. Issue statements on border, economy, Social Security and Medicare, public safety, jobs. Links X and Instagram @Rob4PA and Facebook RobforPA.

    candidate statement

    For: Rob Bresnahan Jr: campaign position

  3. ICYMI: Bresnahan Sends Letter to House Leadership Affirming Commitment to Medicaidhttps://bresnahan.house.gov/media/press-releases/icymi-bresnahan-sends-letter-house-leadership-affirming-commitment-medicaid

    Office of Rep. Rob Bresnahan · Published Apr 17, 2025 · Reviewed Oct 1, 2026

    Release of April 17, 2025, with the text of a letter from Bresnahan and 11 other Republicans to House leaders.

    official office record

    For: Rob Bresnahan Jr: campaign position; Rob Bresnahan Jr: record does not settle this

  4. Bresnahan Statement on Reconciliation Votehttps://bresnahan.house.gov/media/press-releases/bresnahan-statement-reconciliation-vote

    Office of Rep. Rob Bresnahan · Published May 22, 2025 · Reviewed Oct 1, 2026

    Release of May 22, 2025, on the House's first passage of H.R. 1. Says Medicaid will be protected and lists the work-requirement exemptions.

    official office record

    For: Rob Bresnahan Jr: campaign position; Rob Bresnahan Jr: record does not settle this

  5. Roll Call 145, H.R. 1, on passagehttps://clerk.house.gov/Votes/2025145

    Office of the Clerk, U.S. House of Representatives · Published May 22, 2025 · Reviewed Oct 1, 2026

    Recorded vote of May 22, 2025, passed 215-214 with one Present. Bresnahan: Yea.

    official legislative record

    For: Rob Bresnahan Jr: record does not settle this

  6. Roll Call 190, H.R. 1, on concurring in the Senate amendmenthttps://clerk.house.gov/Votes/2025190

    Office of the Clerk, U.S. House of Representatives · Published Jul 3, 2025 · Reviewed Oct 1, 2026

    Recorded vote of July 3, 2025, passed 218-214. Bresnahan: Aye.

    official legislative record

    For: Rob Bresnahan Jr: record does not settle this

  7. Public Law 119-21 (H.R. 1, 2025 reconciliation act)https://www.govinfo.gov/content/pkg/PLAW-119publ21/html/PLAW-119publ21.htm

    U.S. Government Publishing Office · Published Jul 4, 2025 · Reviewed Oct 1, 2026

    Enacted July 4, 2025. Sec. 70101 makes the lower income-tax rates permanent; sec. 70201 creates the no-tax-on-tips deduction; secs. 71101-71102 pause the 2023 and 2024 Medicaid, CHIP and Medicare Savings Program enrollment rules until September 30, 2034; sec. 71107 sets six-month eligibility checks for expansion adults; sec. 71110 limits the expansion match rate for emergency care for certain non-citizens; sec. 71112 cuts back-dated coverage to one month before application for expansion adults and two months for all other enrollees, from three; sec. 71115 lowers the provider-tax threshold; sec. 71119 requires Medicaid work requirements with exemptions; sec. 90001 appropriates $46,550,000,000 for border barriers and the wall system. The 90 per cent expansion match rate in SSA 1905(y) is not amended.

    official legislative record

    For: Rob Bresnahan Jr: record does not settle this

  8. Supplemental Cost Estimate: Public Law 119-21, Title VII, Subtitle B, Chapter 1, Medicaidhttps://www.cbo.gov/publication/61837

    Congressional Budget Office · Published Oct 28, 2025 · Reviewed Oct 2, 2026

    Read in the owner's browser because the site blocks scripts. CBO estimates the Medicaid chapter leaves 7.5 million more people uninsured in 2034.

    official legislative record

    For: Rob Bresnahan Jr: record does not settle this