The U.S. Senate passed a version of the budget reconciliation bill that includes deep cuts to Medicaid and other programs that support health care and food access. The bill now returns to the House, where lawmakers could vote on it at any time.
The legislation is an extension of former President Donald Trump’s 2017 Tax Cuts and Jobs Act. If passed, it would make most of those tax cuts permanent while increasing funding for border security, defense and energy production. To offset the cost, the bill includes cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP).
The Congressional Budget Office projects the Senate’s version would add $3.3 trillion to federal deficits over the next decade and leave millions without health insurance. Proposed changes to Medicaid include work requirements for some able-bodied adults and more frequent eligibility checks.
Sen. Thom Tillis of North Carolina issued a statement last Saturday opposing the bill.
“I did my homework on behalf of North Carolinians, and I cannot support this bill in its current form,” Tillis said. “It would result in tens of billions of dollars in lost funding for North Carolina, including our hospitals and rural communities.”
He warned the cuts could force the state to remove thousands of people from Medicaid and reduce services for those still covered. Tillis called on the Senate to consider the House’s approach instead, which he said focuses on reducing fraud and includes work requirements for some able-bodied adults.
“There is a lot for North Carolinians to love about the rest of the One Big Beautiful Bill,” he said, pointing to extended tax cuts, an increased child tax credit, more border security funding and reduced wasteful spending. “We can and must accomplish this without hurting our rural communities and hospitals, and without jeopardizing access to care for hundreds of thousands of North Carolinians who need it the most.”
Medicaid plays a major role in supporting children and child care services across North Carolina:
• More than 1.4 million children are enrolled.
• 17 percent of child care workers rely on it.
• Medicaid pays for half of all births in the state.
• It supports 54 percent of students with special education plans.
• Nearly half of children with special health care needs are covered.
Cuts to Medicaid could impact organizations that serve children and families, such as Richmond County Partnership for Children, which helps support early childhood programs that depend on Medicaid funding.
In December 2023, North Carolina expanded its Medicaid program, extending coverage to more than 600,000 adults earning up to 138 percent of the federal poverty level. That includes individuals making around $20,000 a year or a family of three earning about $34,000.