North Carolina sends $300M to Medicaid

North Carolina lawmakers approved a $319 million Medicaid funding bill on Tuesday and sent House Bill 696 to Gov. Josh Stein. (abc11.com) (wunc.org) The House passed the measure 112-3, and the Senate followed 45-3, after months of negotiations among Republican leaders, Stein’s office and the Department of Health and Human Services. (spectrumlocalnews.com) (abc11.com) The money comes from North Carolina’s Medicaid reserve and is meant to keep the program funded through June 30, the end of the fiscal year. Stein and Health and Human Services Secretary Dev Sangvai had been asking for that amount for months. (wunc.org) (newsfromthestates.com) State officials had warned lawmakers that Medicaid could run out of money in May if they did not act. The program covers more than 3 million North Carolinians. (wral.com) (spectrumlocalnews.com) The bill is not only a cash infusion. It also starts putting into state law changes tied to last year’s federal H.R. 1, including work requirements for some Medicaid recipients ages 19 to 64. (wunc.org) (medicaid.ncdhhs.gov) Another provision says coverage for people who are not U.S. citizens will be limited to the level required for federal Medicaid participation. Department officials said that language could affect about 27,000 people, including roughly 26,500 children and 500 pregnant women who now qualify under a state waiver. (wunc.org) (newsfromthestates.com) Republican leaders disputed that reading. Senate leader Phil Berger said the provision would not take effect until October and said lawmakers had time to fix any problem if federal guidance later showed one existed. (abc11.com) Democrats who voted no said the bill tied must-pass Medicaid money to new restrictions on immigrant families. Sen. Natalie Murdock said families could avoid applying for benefits if they feared immigration enforcement exposure. (abc11.com) (newsfromthestates.com) The funding fight comes less than three years after North Carolina expanded Medicaid under the Affordable Care Act. As of March 2026, more than 720,000 people had enrolled through that expansion. (medicaid.ncdhhs.gov) (nclocal.org) Stein was reviewing the bill Tuesday evening. If he signs it, North Carolina will avert an immediate Medicaid cash shortfall, while leaving the coverage fight over work rules and immigrant eligibility for the months ahead. (newsfromthestates.com) (abc11.com)