Protecting Nebraska’s Most Vulnerable Voters: Their Vote. Their Choice.
Every eligible Nebraskan deserves the opportunity to exercise the right to vote. Just as importantly, every Nebraskan deserves to know that the choice reflected on their ballot is truly their own.
That principle is especially important for elderly and vulnerable Nebraskans living in nursing homes and other long-term-care settings.
On July 20, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a Quality & Safety Special Alert addressing the voting rights and autonomy of residents in Medicare- and Medicaid-certified nursing facilities. The memorandum does not create new regulatory requirements; instead, CMS says it reinforces facilities’ existing obligations.
The guidance underscores an important principle:
Residents have the right to vote. They also have the right to decline to participate.
Both rights deserve protection.
Voting assistance should protect the voter—not replace the voter
Federal regulations require covered facilities to allow residents to exercise their rights without interference, coercion, discrimination, or reprisal. CMS specifically reminded facilities that they may not register residents to vote without their knowledge or consent or complete a mail ballot on a resident’s behalf without authorization.
Residents who need assistance should also have options. CMS says they should be able to receive assistance from a person of their choosing and should be offered the option of assistance from an authorized representative. The agency also encourages nursing homes to coordinate with state election officials regarding bipartisan election workers where state law permits, reducing reliance on facility staff and the potential for undue influence.
These protections are not about preventing elderly Nebraskans from voting.
They are about protecting their autonomy when they do.
A voter who needs help reading a ballot, physically marking a choice, or navigating the voting process should receive lawful assistance. But assistance should never become substitution. A caregiver, facility employee, political activist, or anyone else should not decide whether another citizen votes or which candidates that citizen chooses.
The ballot belongs to the voter.
A new resource for families
The Election Integrity Network’s Protecting Vulnerable Voters initiative was developed in response to the new CMS guidance and provides resources for families, facilities, and others seeking to understand these protections.
One particularly useful resource is a six-question conversation guide designed for a spouse, adult child, or trusted friend helping a loved one think through voting.
Importantly, the guide expressly says it is intended for family and friends, not activists. It is a conversation guide, not a court order or a tool for political workers.
The questions explore some basic concepts:
Does the person understand the nature of voting? Can they explain how someone actually indicates a choice in an election?
Do they understand the effect of voting? Do they understand that votes are counted to determine the winner?
Can they make a choice? When presented with two hypothetical candidates and different positions, can they express a preference, or decide they remain undecided?
Can they compare the choices? Can they identify a meaningful difference between the alternatives?
Can they identify a consequence of the choice? Can they explain how an election result might affect them?
Do they appreciate what voting means for them? Can they explain whether they want to participate and why?
There is an important limitation that families should understand: this conversation is not a legal determination of an individual's eligibility or capacity to vote. The guide itself states that when capacity is unclear, the person retains the right to vote, and it cautions against coaching answers, marking a ballot for someone who cannot make a choice, or allowing a stranger to conduct the interview.
That distinction matters.
What Nebraska families can do
If you have a parent, grandparent, spouse or other loved one living in a long-term-care facility, you shouldn't have to be an election-law expert to ask reasonable questions about how voting is handled.
Families can ask a facility:
Who is responsible for coordinating voting-related requests?
What procedures are followed when a resident asks for help voting?
How are staff members instructed to remain neutral?
Who may assist residents with voting materials?
How are concerns about coercion or improper influence handled?
When questions arise, how does the facility coordinate with the appropriate Nebraska election officials?
The goal should never be to discourage participation. It should be to make certain that participation reflects the resident's own wishes.
Protect access. Protect autonomy. Protect the ballot.
As Nebraska's chief election officer, the Secretary of State has an important responsibility to provide clear guidance and work with local election officials so voters, families and facilities understand the rules.
As Secretary of State, I will approach this issue with a straightforward principle:
Protect access to the ballot for every eligible Nebraska voter, and protect every voter from having someone else make that choice for them.
That means making clear information available to families and facilities. It means respecting voters who require lawful assistance. It means encouraging appropriate coordination with election officials. And it means taking allegations of coercion, unauthorized ballot activity, or improper influence seriously while following the facts and the law.
Nebraska's elderly and vulnerable citizens deserve the same dignity and respect as every other voter.
Help them vote when they choose to vote.
Respect their decision when they choose not to.
Never make the choice for them.
Their Vote. Their Choice.
That's not a partisan principle.
It's a fundamental part of protecting the integrity of Nebraska's elections.
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