By Jordan Meadows
Staff Writer
North Carolina lawmakers have approved a sweeping Medicaid funding measure that will keep the state’s program operating through the end of the fiscal year while introducing a series of new eligibility requirements and oversight provisions.
House Bill 696, which passed in both chambers, allocates $319 million from state reserve funds to address a budget shortfall in the Medicaid program. The measure now heads to Gov. Josh Stein.
The federally subsidized program currently provides health coverage to more than 3.1 million North Carolinians—over a quarter of the state’s population—including low-income families, children, seniors, and people with disabilities.
The $319 million infusion matches the shortfall projected by the North Carolina Department of Health and Human Services, driven by higher-than-expected enrollment and rising health care costs. Lawmakers said the funding is necessary to ensure uninterrupted coverage through June.
North Carolina expanded Medicaid in 2023 under the Affordable Care Act, adding more than 720,000 new enrollees as of March 2026. However, uncertainty remains at the federal level following a broader spending plan that would cut Medicaid funding nationwide over the next decade, potentially increasing the financial burden on states.
In addition to funding, the legislation introduces significant policy changes aimed at tightening eligibility and reducing costs.
Medicaid eligibility will be reviewed monthly instead of quarterly, requiring more frequent verification of income, household size, and work status; Beneficiaries will face stricter documentation requirements, limiting the use of self-reported information; Work requirements and six-month eligibility redeterminations will be implemented for certain expansion recipients.
The bill also includes measures to verify citizenship status and prevent ineligible individuals from receiving benefits.
Republican lawmakers, who hold majorities in both chambers, said the changes are necessary to control costs and ensure the program’s long-term sustainability.
“We cannot continue to throw dollars at a program without making changes to protect taxpayers,” said Sen. Benton Sawrey, a Republican and chair of the Senate Health Care Committee.
House Speaker Destin Hall echoed that sentiment, arguing the bill introduces “common-sense guardrails” to improve efficiency and accountability.
Some Democrats raised concerns that the new requirements could create barriers for eligible recipients.
House Minority Leader Robert Reives warned that increased paperwork and more frequent eligibility checks could discourage participation and lead to coverage losses.
“The harder we make it for people… the more chances they’re going to not do it,” Reives said, suggesting that administrative burdens could result in eligible individuals losing access to care.
Sen. Michael Garrett was the lone vote against the bill in the Senate.
