Healthcare (Medicaid)

in committee · North Carolina · House Apr 1, 2025

HB 619: Health Care Security Act.

HB 619, the Health Care Security Act, repeals a law that would have ended Medicaid expansion coverage in North Carolina if federal funding dropped below 90%. This change directly affects the state's Medicaid expansion population, ensuring their coverage remains secure regardless of federal funding fluctuations. The bill removes a specific statutory trigger (G.S. 108A-54.3C) that previously threatened automatic discontinuation of benefits. It does not create new programs or alter eligibility but prevents coverage loss due to federal funding changes. The act becomes effective upon enactment.

Topics ✓ HealthcareSupports HealthcareRepeals Medicaid termination trigger, securing coverage continuity without federal funding fluctuations, directly protecting existing Medicaid expansion benefits.95% confidence

Sub-Topics Medicaid

Track

in committee · North Carolina · House Apr 2, 2025

HB 629: Extend Primary Care Task Force.

HB 629 extends the deadline for North Carolina's Primary Care Payment Reform Task Force from May 1, 2024, to December 31, 2026. The task force studies primary care spending across Medicaid, the State Health Plan, and commercial insurance to evaluate system adequacy, define primary care services, and identify data collection methods. This extension allows the task force additional time to complete its analysis and submit reports to legislative committees, directly affecting state agencies like the Department of Health and Human Services responsible for implementing the study.

Topics ✓ HealthcareSupports HealthcareExtends task force studying primary care funding across Medicaid/insurance to evaluate system adequacy and define services, enabling future healthcare policy improvements.92% confidence

Sub-Topics Insurance Medicaid Primary Care

Track

in committee · North Carolina · House Apr 2, 2025

HB 653: Adjust Federal Medical Assistance Percentage Trigger for Medicaid Expansion.

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.

Topics ✓ Budget & TaxesSupports Budget & TaxesLowers Medicaid coverage trigger, reducing state spending on Medicaid by allowing earlier termination when federal funds drop.90% confidence ✗ HealthcareOpposes HealthcareBill lowers FMAP threshold from 90% to a lower percentage, making Medicaid coverage termination more likely when federal funding decreases, restricting access for expansion recipients.92% confidence

Sub-Topics Medicaid

Track

in committee · North Carolina · House Apr 3, 2025

HB 714: Universal Healthcare.

HB 714 creates a state-run universal healthcare benefit plan administered by North Carolina's Commissioner of Insurance. It requires the plan to offer sliding-scale premiums based on household income, covering residents whose incomes exceed Medicaid eligibility but who cannot afford private insurance. The bill mandates the Commissioner to develop the plan by January 1, 2026, with a report to the legislature detailing implementation steps. It also appropriates $100,000 for initial planning in the 2025-2026 fiscal year and ensures coverage meets or exceeds federal Affordable Care Act standards.

Topics ✓ Budget & TaxesSupports Budget & TaxesAppropriates $100,000 for healthcare plan development, funding a public service expansion under state budget95% confidence ✓ HealthcareSupports HealthcareCreates state-run universal healthcare plan with sliding-scale premiums for uninsured residents above Medicaid, expanding coverage to a new demographic.95% confidence

Sub-Topics Insurance Medicaid

Track

in committee · North Carolina · House Apr 15, 2025

HB 558: Criteria for Prepaid Health Plan Contract Procurement.

HB 558 updates how North Carolina selects Medicaid health plans by limiting statewide contracts to four and allowing up to 12 regional contracts through local health providers. It requires the state to prioritize bids from local providers and those with high provider satisfaction scores from existing contracts. The bill also mandates staggered contract terms (3-5 years) to prevent coverage gaps during transitions. These changes directly affect Medicaid health plan contractors and the Division of Health Benefits, aiming to stabilize coverage and improve provider relationships.

Topics ✓ HealthcareSupports HealthcareBill prioritizes local providers and high satisfaction scores for Medicaid health plans, mandates staggered contracts to prevent coverage gaps, and updates procurement criteria to strengthen Medicaid service continuity and access.92% confidence

Sub-Topics Insurance Medicaid

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passed · North Carolina · Senate May 6, 2026

SB 316: Lower Healthcare Costs.

SB 316 requires North Carolina hospitals and ambulatory surgical facilities to publicly disclose detailed pricing information for common medical services, including full charges, negotiated rates, and reimbursements from Medicaid, Medicare, and major insurers. Beginning in 2015, these facilities must submit quarterly reports to the state health department on the 100 most frequent inpatient diagnoses (DRGs) and common surgical/imaging procedures. The data will be made publicly available online, enabling patients and employers to compare costs and make informed healthcare decisions. This bill directly affects healthcare providers by mandating transparency but does not alter insurance coverage or set price limits. Its key mechanism is standardized reporting of pricing data to foster competition and affordability in the healthcare market.

Topics ✓ HealthcareSupports HealthcareMandates hospital price transparency for common services, improving patient access to cost information and aligning with patient rights and healthcare affordability goals.95% confidence

Sub-Topics Insurance Medicaid Medicare

Track

died · North Carolina · Senate Mar 6, 2025

SB 246: Create 13,000 Jobs Serving People With I/DD.

SB 246 increases North Carolina's Medicaid Innovations Waiver slots by 5,000 for the 2025-2026 fiscal year and another 5,000 for 2026-2027, directly serving approximately 19,000 people with intellectual or developmental disabilities (I/DD) currently on a waiting list. The bill allocates $134 million (2025-2026) and $357.34 million (2026-2027) in state funds to cover a state match for federal funds, enabling these slots to be distributed based on waitlist length. It requires that direct care workers receive at least $20 per hour and ensures unused slots are redistributed to providers meeting wage and service capacity standards. This policy aims to reduce the waiting list, support caregivers in returning to work, and stimulate local economies through new jobs and community-based services.

Topics ✓ Budget & TaxesSupports Budget & TaxesAllocates $134M (2025-26) and $357M (2026-27) in state funds for Medicaid waiver slots, directly increasing budgetary spending for public social services and disability care.95% confidence ✓ HealthcareSupports HealthcareBill expands Medicaid waiver slots by 10,000 (5k/year) for I/DD health services, allocates $491M in state funds to cover federal match, directly increasing healthcare access and funding for vulnerable populations.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentCreates 13,000 new direct care jobs via Medicaid waiver expansion, directly funding employment in healthcare sector per bill's title and EMPLOYMENT subject category.95% confidence

Sub-Topics Medicaid

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passed · North Carolina · Senate Apr 28, 2025

SB 369: Medicaid Telehealth Services.

SB 369 aims to ensure that certain telehealth providers can enroll as Medicaid providers in North Carolina. The bill specifies that individual health care providers, licensed by the state and offering services exclusively through telemedicine, do not need a physical presence in the state to be eligible for Medicaid enrollment. Additionally, medical provider groups that exclusively offer telemedicine services will not be required to have an in-state service address to enroll as Medicaid provider groups. This measure directly affects telehealth providers and Medicaid recipients by clarifying requirements for remote healthcare services.

Topics ✓ HealthcareSupports HealthcareRemoves physical presence requirement for telehealth providers to enroll in Medicaid, expanding patient access to telemedicine services under public health program.95% confidence ✓ TechnologySupports TechnologyRemoves physical presence barriers for telehealth providers, enabling tech-based healthcare access under Medicaid, aligning with emerging technologies subject.90% confidence

Sub-Topics Medicaid Telehealth

Track

passed · North Carolina · House May 27, 2025

HB 485: Adult Care Home Medicaid Personal Care Services Coverage.

HB 485 requires North Carolina's Medicaid agency to request federal approval to extend Medicaid coverage for personal care services to adults living in licensed adult care homes who earn more than the current State-County Special Assistance income limit but stay below 180-200% of the federal poverty level. The bill specifically targets individuals who would qualify for lower-income Medicaid assistance if not for their higher earnings. Before implementing this coverage, the agency must submit a CMS request meeting three conditions: covering the specified income group, ensuring cost savings offset new expenses, and complying with legal requirements. This bill does not immediately change coverage - it only authorizes a federal request, pending CMS approval.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid coverage for personal care services to higher-income adults in care homes, increasing healthcare access for vulnerable populations.95% confidence

Sub-Topics Long-Term Care Medicaid

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signed · North Carolina · Senate Aug 11, 2026

SB 445: Regulatory Reform Act of 2026.

SB 445 automatically adopts federal temporary waivers or modifications issued by the U.S. Department of Health and Human Services or Centers for Medicare & Medicaid Services under specific Social Security Act sections (1135 or 1812(f)) for North Carolina hospitals during declared emergencies. This means hospitals in disaster zones no longer need separate state approval to implement federal rule changes, directly affecting hospitals operating under such declarations. Key provisions include automatically waiving state hospital regulations to align with federal waivers and allowing temporary increases in bed capacity without additional state review. The bill streamlines emergency hospital operations by eliminating bureaucratic delays in applying federally authorized relief measures.

Topics ✓ HealthcareSupports HealthcareAutomates federal waiver adoption for NC hospitals in disasters, removing state approval barriers to maintain healthcare access during emergencies, directly supporting hospital operations under crisis conditions.90% confidence

Sub-Topics Hospitals Medicaid Medicare