In southeastern Michigan, Rep. John James (R-MI) has built a track record of opposing healthcare protections for the 700,000 residents of Michigan’s 10th Congressional District. Now, as he runs for governor, he’ll face increased scrutiny from voters across the state about how he’s balancing what’s best for Michiganders with his desire to support Donald Trump’s policies.
1. James voted to cut $1 trillion from Medicaid and other safety-net programs
Rather than distance himself from President Donald Trump’s healthcare cuts in the “One Big Beautiful Bill,” James became one of the bill’s most vocal defenders. He actually voted yes on the “One Big Beautiful Bill” twice—in May and July 2025—and even appeared on Fox News’ The Ingraham Angle to promote it.
After his May vote, James called it “a huge win for Michigan and the entire country” and praised Trump and House Republicans for “delivering on our promises to usher in a new American Golden Age.”
The reality told a different story. The Congressional Budget Office found the bill would increase federal deficits by $3.8 trillion over a decade while cutting $1 trillion from Medicaid, food stamps, and other services, resulting in millions of Americans losing health insurance. A March 30 Urban Institute analysis now projects that hundreds of thousands of Michiganders will now lose Medicaid coverage by 2028.
“Many poor, older, and disabled people are enrolled in Medicare but use Medicaid to cover copayments they cannot afford. So if their Medicaid is taken away, as it could be under the legislation Congressman James voted for, these seniors and disabled people might not be able to pay their co-payments or other costs,” said Dr. Christine Crader, a palliative medicine physician from St. Clair Shores, in an interview with Michigan Advance.
2. James voted to slash $6 billion from Michigan’s Medicaid program
Beyond Trump’s bill, James voted for a 2025 budget resolution that cut $6 billion from Michigan’s Medicaid program and $900 million from SNAP food assistance to fund tax breaks for the wealthy. This vote directly impacted 182,000-210,000 of his own constituents who rely on Medicaid for healthcare access—representing roughly 21-30% of his district.
Lt. Governor Garlin Gilchrist bluntly told constituents at a July 2025 town hall that James “voted to strip and rip healthcare” from vulnerable Michiganders, including 41,000 veterans statewide who receive Medicaid services. Michigan Families for Fair Care warned that an estimated 89,000 Michiganders on the lifesaving program risked losing coverage.
The Michigan Democratic Party Chair condemned James for voting “to cut Medicaid for half a million Michiganders during markup in the House Committee on Energy and Commerce” in May 2025, calling him “a disgrace to our entire state and the millions of Michiganders that rely on Medicaid.”
3. James voted to raise health insurance premiums for nearly 500,000 Michiganders
In January 2025, James voted against a bipartisan extension of the Affordable Care Act’s enhanced tax credits, causing premiums to spike for 460,000 Michiganders when the subsidies expired on January 1, 2026.
When the House voted on a bill in January 2026 to extend ACA tax credits for three years, James refused to sign onto the bipartisan discharge petition that forced the vote and did not vote to advance the bill. James has consistently called the ACA a “monstrosity” and previously advocated for its repeal.
By December 2025, James was touting his vote for Trump’s tax law “that gutted Medicaid and failed to extend ACA” subsidies even as healthcare prices skyrocketed.
4. James voted to terminate the COVID-19 vaccine requirement for healthcare workers
In January 2023, James voted for the “Freedom for Health Care Workers Act” to terminate the COVID-19 vaccine mandate for healthcare workers and prevent the Centers for Medicare and Medicaid Services from enacting similar requirements in the future. The measure passed 227-203 and eliminated vaccine requirements for hospitals, nursing homes, and other providers receiving federal Medicare or Medicaid funding.
This vote positioned James against vaccine mandates at a time when public health experts emphasized vaccination as crucial for protecting vulnerable patients in healthcare settings.
5. James repeatedly attacked reproductive healthcare access
James has amassed an extensive anti-reproductive health voting record, including votes to eliminate funding for the Office of Population Affairs, which administers critical reproductive health programs.
Despite being a former servicemember himself, he voted to ban payment or reimbursement for abortion services for military servicemembers and their dependents. He also supported legislation targeting access to mifepristone (a prescription medication used for IUD insertions, miscarriage treatment, and abortions), and backed defunding Planned Parenthood, calling continued federal funding a “tragedy.”
In 2024, James voted to reduce the salary of the FDA’s Director of Medical Policy to $1 as part of ongoing attempts to limit access to mifepristone, and supported eliminating funding for the White House Gender Policy Council charged with advancing gender equity and reproductive freedom.
And now: Measles in Macomb County
On April 23, 2026, Macomb County—the heart of James’s district—confirmed its first measles case of the year, bringing Michigan’s total to 10 confirmed cases. The Macomb County Health Department said there were no known public exposure sites but was working to notify individuals who might have been exposed.
Across the country, Americans have experienced 22 measles outbreaks in 2026, with a staggering 1,792 confirmed cases—93% of them (1,668 cases) outbreak-associated. The Michigan Department of Health and Human Services issued an unprecedented recommendation in April 2026 for infants ages 6-11 months in Washtenaw, Monroe, Wayne, Oakland, Jackson, Livingston, and Lenawee counties to receive an accelerated first dose of measles vaccine due to ongoing community transmission.
Health officials have noted that 92% of measles cases in 2026 so far are among unvaccinated individuals, as vaccination rates have dropped across Michigan in response to the MAGA-supported anti-vax movement.
The convergence of James’s votes against vaccine mandates, his championing of Trump’s bill that would cut $1 trillion from Medicaid (which provides vaccine access for low-income families), and the emergence of a preventable disease outbreak in his own district paints a stark picture of the consequences when elected officials prioritize ideology over public health.
When confronted about the impact of his votes, James has refused to defend his record andsidestepped questions about Medicaid cuts.
