HB 46 requires that any new state law creating health benefit mandates (like coverage requirements or provider rules) must also repeal an equal number of existing mandates and include funding for the new mandate. It directly affects North Carolina legislators, employers (especially small businesses), and taxpayers by changing how health insurance rules are added or removed. Key provisions include defining "health benefit mandates" broadly (e.g., coverage requirements, cost-sharing rules) and mandating that new mandates must be paired with both repeal of existing mandates and dedicated funding. The bill applies to future legislation considered by the General Assembly, starting 30 days after enactment, and also updates rules for the State Health Plan for Teachers and State Employees.
HB 89, the "University Vaccination Freedom Act," repeals North Carolina's requirement for college and university students to provide vaccination records. It removes the mandate for students to submit immunization certificates to institutions, effective for the 2026-2027 academic year. The bill retains existing religious exemption provisions (G.S. 130A-157), allowing students to opt out by submitting a written statement of religious beliefs. This change directly affects all students attending public or private colleges and universities in North Carolina.
SB 24 requires that any new state health insurance mandate must be paired with the repeal of an existing mandate and include funding to cover the new cost. It directly affects North Carolina employers (especially small businesses) and taxpayers by targeting mandates that increase insurance premiums and state health plan expenses. Key provisions mandate that new health benefit requirements (like coverage for specific treatments or drugs) must include both a repeal of an equivalent existing mandate and recurring state funding for the new cost. The bill applies to all health insurance plans, including the State Health Plan for Teachers and State Employees, and takes effect 30 days after enactment.
HB 380 would allow North Carolina students to opt out of school vaccination requirements by submitting a written statement citing personal beliefs (a "conscientious objection"), rather than requiring proof of religious affiliation. It amends immunization reporting rules to include "conscientious objection" as a formal exemption category alongside medical and religious exemptions for public schools and colleges. Parents or guardians would need to provide this written statement instead of religious documentation to exempt their child from vaccination mandates. The policy change applies to public schools and colleges starting in the 2026-2027 school year.
SB 727 adjusts North Carolina's Medicaid program by reducing the maximum number of regional contracts awarded to provider-led groups (PLEs) from up to 12 to up to 4 per contract cycle. It maintains four statewide contracts for commercial health plans to cover Medicaid recipients across the state. The bill requires the state to award contracts based on provider responses to requests for proposals, ensuring coverage continuity if fewer than four providers meet requirements. This directly affects Medicaid recipients, commercial health insurers, and provider-led groups managing regional or statewide coverage.
HB 653 lowers the federal funding threshold that would trigger loss of Medicaid coverage for North Carolina's newly eligible expansion recipients. Currently, coverage would end if federal funding for this group drops below 90% compared to non-expansion recipients; the bill reduces this threshold to a lower percentage. If funding falls below the new threshold, Medicaid coverage for this group must discontinue promptly, with state agencies required to notify lawmakers and CMS. The bill affects only those added to Medicaid through the 2014 expansion, not all Medicaid beneficiaries.
This bill requires North Carolina's Commission for Public Health to wait at least three years after a vaccine receives U.S. Food and Drug Administration (FDA) approval before adding it to the state's childhood immunization schedule. It allows exceptions only if both the North Carolina Medical Society and North Carolina Pediatric Society recommend adding a vaccine approved for less than three years. The law directly affects the Commission's authority to update vaccination requirements for school-aged children and the medical societies' role in advising on shorter-approved vaccines. It does not change existing vaccination requirements or exemptions for medical reasons.
HB 844, the Finding Grace Family Bill, revises North Carolina's adoption and abortion laws. It requires the state to provide adoptive families with resources to prevent adoption dissolution (such as counseling and support services) and clarifies parental consent processes before birth (e.g., allowing biological mothers to seek court determination of consent after three months of pregnancy). The bill bans most abortions after 12 weeks of pregnancy, with exceptions for medical emergencies and procedures performed within the first 12 weeks. These changes directly affect adoptive families, prospective adoptive parents, and individuals seeking abortion care in North Carolina.
HB 1000 establishes legal restrictions on gender transition care for minors in North Carolina while creating pathways for detransition. It prohibits medical professionals from performing surgical gender transitions, prescribing puberty blockers or cross-sex hormones, or conducting detransition procedures on minors without parental consent (with detransition procedures specifically permitted under parental consent). The bill imposes penalties including license revocation for violations and mandates civil liability for medical providers who provide transition care to minors, requiring them to cover harms like physical, psychological, or emotional injuries. It also requires gender clinics to report detailed statistics on transition procedures to the state health department. This bill directly affects minors seeking gender-affirming care, their parents/guardians, and medical providers operating gender clinics in North Carolina.
