Days before the midterm elections, Senate Democrats are pushing for the Trump administration to drop guidance aimed at preventing ballot harvesting or coercive voting practices in nursing homes.
Sens. Elizabeth Warren, D-Mass., and Alex Padilla, D-Calif., along with six others, wrote to Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, asking him to rescind a July memo to nursing homes.
“We write to reiterate our request that you rescind the July 2026 memorandum and seek clarification about any connections between CMS and these election denial groups. This is a particularly urgent matter given that Election Day is only one week away,” the letter says.
Sens. Richard Blumenthal, D-Conn., Mazie Hirono, D-Hawaii, Ron Wyden, D-Ore., Cory Booker, D-N.J., Kirsten Gillibrand, D-N.Y., and Jeff Merkley, D-Ore., joined in signing the letter.
As previously reported by the Daily Signal, ballot harvesting and voting coercion in nursing homes have been longstanding problems.
The CMS memo from late July cited two major cases in recent years, one in Texas and another in Wisconsin, involving elderly people being exploited in long-term care facilities to collect votes. The memo says facilities have a “responsibility to preserve residents’ rights to vote and to promote participation in the democratic process.” It adds, “This activity should not violate federal or state voting laws.”
Activist groups have been known to collect ballots from facilities with no assurance that the ballots won’t be tampered with, according to the Center for Vulnerable Voters, and advocacy group affiliated with the American Constitutional Rights Union.
A Government Accountability Office report in 2009 noted that seniors in long-term care facilities are “vulnerable to fraud and undue influence from relatives, long-term care facility staff, campaign workers, or candidate supporters.”
The GAO report further notes, “According to researchers, requiring local election officials to deliver absentee ballots in person to facilities or conduct on-site absentee balloting at facilities, which some states require or allow, can decrease the likelihood of fraud and inappropriate influence by eliminating the need for assistance from influential third parties.”
This is the second such demand from Senate Democrats. In August, Warren and Padilla led a total of 13 Senate Democrats opposed to the anti-ballot harvesting measure.
In September, Oz wrote back to the senators.
“The July 2026 memo does not eliminate nursing homes’ obligations to support resident voting rights. Instead, it reiterates those obligations with an added emphasis on resident autonomy, ensuring that residents are empowered to make their own voting decisions without interference, pressure, or coercion from facility staff or others,” Oz told the senators.
“The updated guidance was issued to protect the autonomy and rights of nursing home residents, including their right to vote free from undue influence or coercion,” Oz continued. “CMS believes that safeguarding residents from potential manipulation is fully consistent with and required by Medicare requirements.”
In response, senators upped their demand.
“We are deeply concerned that CMS’s failure to rescind its July 2026 memorandum is enabling election denial groups to intimidate nursing home staff from assisting residents with voting, and may ultimately inhibit the ability of nursing home residents to exercise their constitutional rights,” the Wednesday letter says.
The Election Integrity Network released a toolkit for instructing senior facilities on how to comply with the CMS guidance. Among other things, the toolkit suggests that facilities or caregivers avoid assumptions and ensure a resident expresses interest in voting; refer that interest promptly to a designated voting coordinator; and protect the resident’s choice and ensure there is no pressure to vote for or against a candidate.
An industry group, the American Health Care Association/National Center for Assisted Living, notes the CMS memo was not a new process but a reminder of existing guidelines.
“AHCA/NCAL and our members are committed to ensuring that residents retain their statutory and constitutional right to vote, while taking appropriate steps to maintain the integrity of the voting process,” Holly Harmon, senior vice president of quality, regulatory and clinical services for the industry group, previously told the Daily Signal.
In 2020, Texas state officials charged a social worker with 134 felony counts of election fraud for registering residents of the Mexia State Supported Living Center allegedly without their consent. The social worker eventually pleaded guilty to lesser charges, and no improper votes occurred.
In Wisconsin, Racine County Sheriff Christopher Schmaling investigated a case in 2021 alleging that eight people whose mental capacities had diminished due to age or disease had cast mail-in ballots from Ridgewood Care Center. However, the local prosecutor said “my hands are tied” because of a jurisdictional issue and would not bring a case.
Last year, a Mississippi woman was convicted of violating the state’s ballot harvesting law when she visited senior citizens’ homes to collect ballots for the 2023 Democratic primary.
In 2022, a nursing home employee in Michigan pleaded guilty to three misdemeanor charges after being charged with forging signatures on absentee ballot applications.
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[ H/T The Daily Signal ]
