How SNAP, Medicaid cuts in megabill passed in Senate could affect millions of North Carolinians

(WGHP) — President Donald Trump has been fighting for his domestic policy bill for weeks, but some feel it’s shaping up to be a big betrayal.

Medicaid was expanded in North Carolina with bipartisan support in December 2023, allowing roughly 670,000 people to access benefits, totaling 3.1 million people who qualify.

Proposed changes to the Supplemental Nutrition Assistance Program could cost the state $700 million to continue serving the more than a million people currently on the program or face cutting eligibility.

“This bill is anything but beautiful,” said NC Governor Josh Stein on Tuesday.

Stein had strong words opposing the bill and the potential consequences it could have for North Carolinians.  

“Over 1.4 million North Carolinians rely on SNAP,” said NC Health and Human Services Policy Director Karen Wade in a briefing prior to the Senate vote.

“And … 600,000 of them are children,” Stein said.

Wade shared data about the potential effects of federal legislation.

“Since its creation 50 years ago, SNAP benefits have been 100 percent federally funded. Both House and State propose changing this, requiring states to fund a portion of the benefit costs, leaving NC with a new unprecedented, unfunded mandate,” Wade said.

She composed a slide showing how the state’s portion would be calculated, showing NC would have to come up with $700 million in the House version and $420 million in the Senate version.

“There’s going to be hundreds of thousands of people who lose their health insurance,” Stein said.

NC Senator Thom Tillis, who announced he is not running for re-election, was one of the only Republicans not to support the bill, calling it a betrayal based on Medicaid cuts.

“It is inescapable that this bill and its current form will betray the very promise that Donald J. Trump made,” Tillis said.

NC Senator Tedd Budd disagreed, posting a thread on social media claiming Medicaid subsidies could balloon if not checked.

He concluded by saying nobody is voting to take Medicaid from those the program was designed to serve and the goal is to slow cost increases.

NCDHHS Deputy Secretary of Medicaid Jay Ludlam explained in the briefing prior to the vote how the cuts could affect hundreds of thousands of people.

“Our program provides coverage to one in four North Carolinians,” Ludlam said.

The Senate proposal would eliminate the $6.5 billion Healthcare Access and Stabilization Program.

It’s a program that pays hospitals at a rate closer to the actual cost of care for Medicaid-covered expenses, meaning it’s a program to help people get care who can’t afford it otherwise that keeps the hospitals above water financially.

“This has been a lifeline for our rural hospitals in NC,” Ludlam said.

Their research indicates the loss of Medicaid funding would range from $37 billion to $39 billion over a decade.