The Center for Healthcare Affordability scorecard tracks healthcare reform and limited-government healthcare positions based on substantive votes cast by members of Congress and state legislators. Each lawmaker receives a score reflecting how often they voted in alignment with these positions.

Scores are calculated as the percentage of weighted substantive votes a lawmaker cast in alignment with Reform Healthcare's position. Bills are weighted by Center for Healthcare Affordability's research team. See the methodology page for full details on weighting and the participation threshold for receiving a finalized rating.

A high score (90%+) means a lawmaker voted in alignment with Reform Healthcare's positions on nearly every substantive vote. A low score means they voted against Reform Healthcare's positions on most substantive votes. Lawmakers below the participation threshold are marked N/A.

Use the state and year filters above to narrow the leaderboard, or search by name. Each lawmaker's row links to their full profile, including a year-by-year voting record and category breakdown.