Fact Sheet: Protecting North Carolinians from Federal Medicaid Cuts

Fact Sheet: Governor Stein Focused on Protecting North Carolinians from Federal Medicaid Cuts 

When more people are uninsured, hospitals and clinics face more unpaid care, people may be forced out of the workforce without treatment, families take on more medical debt, and everyone is forced to cover the cost of care through higher premiums. Medicaid is a lifeline for more than 3 million North Carolinians, but because of impending federal Medicaid cuts caused by H.R. 1, more than 250,000 North Carolinians covered by Medicaid expansion are at risk of losing health care coverage, which will raise costs for all North Carolina taxpayers.   

Governor Stein and NCDHHS are publicizing a Know What’s Next toolkit so that families can learn who is impacted by Medicaid changes and how they can keep their health care. 

 How will H.R. 1 impact Medicaid and health care in NC? 

• More than 250,000 North Carolinians could lose health coverage because of H.R. 1.  

• North Carolina will lose out on tens of billions of health care dollars over the next decade. 

• NC rural hospitals alone are projected to lose $3.7 billion over 10 years.   

I don’t get health insurance through Medicaid. How will these cuts impact me?  

• Higher premiums: When people lose their insurance, they don’t stop getting sick. When someone can’t afford to get preventative care—like annual check-ups or cancer screenings—manageable health problems can turn into crises. Health crises land more people in emergency department, where care is far more expensive. And that E.R. bill doesn’t disappear. Instead, hospitals and clinics face more uncompensated care, and all of our premiums go up. 

• Worse coverage in rural NC: For hospitals already operating on thin margins like many in rural North Carolina, Medicaid budget cuts can mean cutting services, consolidating, or closing altogether. When the only hospital or maternity ward within driving distance closes, it does not matter what kind of insurance card is in your wallet. Everyone in that community has lost access to care. 

What should I do next to keep my coverage? 

North Carolina cannot undo federal cuts; only Congress can. But we can help people hold on to the health coverage they are eligible for. 

Starting January 1, 2027, many adults in North Carolina with NC Medicaid expansion coverage will be required to prove they are working, going to school, or volunteering 80 hours a month, and they will be required renew and verify their eligibility every six months instead of annually. Every person who has NC Medicaid should: 

• Check that your local Department of Social Services (local DSS) has your current address and phone number. Your local DSS will write to you about these changes. If your address is wrong, you could lose your Medicaid without knowing why. Update your address online at ePASS or call your local DSS. 

• Answer any letter right away. Letters from your local DSS usually have a deadline. Missing a deadline is a common reason people lose their Medicaid. 

• Get an enhanced ePASS account if you do not have one. You need an enhanced account to upload documents you may need to share to keep your Medicaid coverage.  

Click here to learn more about who is affected by NC Medicaid changes and how you can keep your health care coverage.