NC Medicaid Deal Stalls Despite Bipartisan Backing

Governor Josh Stein speaking on Sep. 25th about Medicaid cuts, criticizing state leaders of playing political games rather than finding common ground. Source: ABC11.

The federal cuts to Medicaid have begun to hit states hard, especially those that rely heavily on federal funding to keep their Medicaid programs running. In North Carolina, federal funding is responsible for 65 to 90 percent of Medicaid costs, requiring state lawmakers to revise budget plans and pass legislation to make up for the financial deficit. 

North Carolina lawmakers have been conflicted over providing additional state funding; not acting could prove devastating to the more than three million North Carolinians relying on Medicaid, most of whom live in rural counties. At the beginning of the fiscal year in July, legislators needed to approve $819 million in funding for Medicaid to avoid cutting reimbursement rates for hospitals and medical providers. But, only $600 million was supplied, with lawmakers wanting more time to discuss if more funding was actually necessary. If Medicaid funding is not provided by October 1st, access and coverage could be substantially cut. 

The North Carolina House and the Senate both passed their own versions of bills to fund the program, but are arguing over whether to include funding for the NC Children’s, a pediatric hospital network led by Duke and UNC Health. In 2023, both chambers set aside $320 million for this project, but the House now believes that this money could be better used for other pressing matters. Therefore, the House’s bill calls for only funding the $690 million necessary for Medicaid. The Senate’s bill includes this amount, but also adds the $103.5 million needed to fund the hospital.

 Since the beginning of the fiscal year, Republicans in the House and Senate have been at an impasse on creating a comprehensive spending plan. Chamber leaders have been in disarray on  whether to cut taxes or give raises to state employees. These debates have culminated in the latest Medicaid budget talks and are the beginning of a road of uncertainty for many North Carolinians.   

Lawmakers have yet to pass the state budget, and have instead opted to agree on a smaller bill including spending for the State Highway Patrol and step increase raises. Despite Medicaid’s substantial role in funding rural hospitals and providing for 35% of residents in low-income counties, it seemingly is not reasonable enough for the government to expedite talks or set its power struggle aside for the sake of the people. 

While North Carolinians cast blame at the General Assembly, its members are looking to criticize the Democratic minority instead. The Republican led Assembly has begun to point fingers at Democrats for having ulterior motives to create an issue in the 2026 elections, comments that further contribute to the political party polarization narrative. With dangerous Medicaid decisions looming at the expense of millions, especially those in rural areas, the Republican-backed decisions could cause some citizens to reconsider their political loyalties. 

The Governor has expressed his concerns, voicing that he does not want to push the October 1st deadline back, and rather wants lawmakers to convene to solve the problems themselves. Stein has also spoken about how the lack of agreement is hurting the healthcare system and the economy, but his words have yet to make an impact on the Assembly's decision.

The seeping of political infighting into the daily lives of citizens could prove disastrous not only in terms of Medicaid, but also for the trust people have in their government. If elected representatives are unable to make progress on issues that matter most to the people, the assurance put into governmental figures, bills, and actions will begin to dwindle, hindering the effectiveness of state politics. Furthermore, as officials continue to point fingers at each other rather than find common ground, the NC Government remains gridlocked, struggling to move forward with meaningful legislation and disappointing citizens who are desperate for results. If this indecisiveness continues to spill over into other key issues, it could lead to backlash from voters in the upcoming 2026 elections.