Gov. Josh Stein signed a bill approving $319 million in Medicaid funding on April 30, 2026. (Photo: Christine Zhu/NC Newsline)
Gov. Josh Stein signed a bill Thursday approving $319 million in Medicaid funding, ending months of uncertainty over the program’s future.
More than 3 million North Carolinians rely on Medicaid for healthcare. Without a state budget, N.C. Health and Human Services Secretary Dev Sangvai warned the program would run out of money by the end of May.
Stein urged state lawmakers to supply adequate recurring funding next year to keep the program stable.
“For months, the status of Medicaid in North Carolina has been in unnecessary jeopardy,” Stein said before signing the document. “I’m relieved to say that the bill that I will be signing will provide certainty and care that the people and the providers of this state need and deserve.”
House and Senate lawmakers voted nearly unanimously to pass House Bill 696, “Medicaid & HHS Adjust./Other Critical Needs,” earlier this week.
Three Democrats in each chamber voted against it, saying it would deny Medicaid coverage to 27,000 pregnant women and their children due to their immigration status. The group includes victims of human trafficking, green card holders, refugees and other immigrants with legal status, as well as undocumented immigrants who are pregnant or who have recently given birth.
Gov. Josh Stein signed a bill approving $319 million in Medicaid funding on April 30, 2026. (Photo: Christine Zhu/NC Newsline)Stein said he was concerned with that part of the bill, but noted the urgency of funding the program before it runs out of money.
“Depriving these vulnerable women and children healthcare converge is wrong,” Stein said. “Fortunately, based on conversations we’ve had, I believe that it is the General Assembly’s intention to fix this.”
But that’s not the only provision in the bailout bill causing concern. H696 also creates new copays for Medicaid at the maximum amount allowable by federal law.
A coalition of 14 nonpartisan organizations representing patients with serious and chronic health conditions, including the American Cancer Society Cancer Action Network, urged policymakers to reconsider the copay amounts.
“Research has shown that even low levels of cost-sharing and copayments deter patients from seeking care,” the coalition said in its statement.
H696 also includes some of the nation’s most restrictive requirements for eligibility. Federal law requires a minimum one-month lookback period, which is the timeframe for checking work-requirement eligibility for benefits like Medicaid. But H696 requires Medicaid to verify three months of work eligibility before applicants receive approval.
“There may be people who are eligible for Medicaid that are denied benefits because of this longer lookback,” Stein said.
Looking ahead, the program has a $1 billion rebase, or increase in costs, for the upcoming fiscal year, according to Sen. Benton Sawrey (R-Johnston), co-chair of the Joint Legislative Oversight Committee on Medicaid. That’s larger than the expected surplus in the state budget.
With rising prices, Sawrey said Medicaid costs have increased by more than 90% over the past five years in North Carolina.
“House Bill 696 takes important first steps in giving our Medicaid partners important tools in order to manage that cost,” Sawrey said. “I’m proud of the work that we did to get this across the finish line, but I don’t have any illusions that this is the current solution that’s going to fix everything going forward.”
North Carolina General Assembly gives final approval to $319M in Medicaid funding
Josh Dobson, president and CEO of the North Carolina Health Association, said the law provides relief for providers in addition to patients. The funding supports the providers and teams who make healthcare possible.
Healthcare workers are stepping up while managing workforce challenges and significant financial pressure, he said.
“Through all of that, they continue to deliver high quality care in every single corner of North Carolina,” Dobson said. “They stayed engaged, worked in good faith and helped move forward an approach that supports patients while strengthening the system for the long term.
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SUPPORTThe law also contains measures to target waste and abuse in Medicaid. The House Select Committee on Oversight and Reform grilled Sangvai and Attorney General Jeff Jackson earlier this month over allegations of fraud.
Some critics said the measure moved jurisdiction over fraud away from the attorney general to the state auditor’s office, but bill sponsors said that’s not the case.
Sangvai lauded the push for agencies to work together to identify and address cases of waste and abuse.
“One of the other opportunities that’s come out of this process is collaboration in the state,” he said.
Stein isn’t worried about the potential power shift, he said, since the attorney general — a position he previously held — partners with the governor’s office against Medicaid fraud.
“The government is really focused on it, because we want every healthcare dollar to go to make someone healthy,” he said.
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