1. United States
2. N.C.
3. Letter

Projections from multiple analyses indicate that hundreds of thousands of North Carolinians could be negatively affected by the federal GOP budget enacted in July 2025. However, the exact number of people affected varies depending on the specific provisions and how they are implemented at the state level. Potential impacts on North Carolinians Medicaid coverage loss: The Congressional budget includes significant cuts to Medicaid. Sources cite ranges from over 600,000 to potentially 670,000 people being at risk of losing their health coverage. The reasons for this include: New work reporting requirements for Medicaid recipients. Changes to federal funding formulas that could "trigger" a state law ending North Carolina's Medicaid expansion. Increased healthcare costs: The budget did not extend enhanced premium tax credits for health insurance purchased through the Affordable Care Act (ACA) marketplace. This could cause costs to skyrocket for low- and middle-income families, and an estimated 74,000 North Carolinians could lose their health coverage as a result. Reduced food assistance: Cuts to the Supplemental Nutrition Assistance Program (SNAP) could impact hundreds of thousands of North Carolinians. New work requirements and a shift in costs to the state could put at risk an estimated 143,000 people's food assistance. Strain on hospitals: Rural hospitals are expected to be hit particularly hard by the Medicaid cuts, with some at risk of closing. A loss of federal funding could also lead to reduced access to care and increased costs for everyone. Loss of protections for vulnerable populations: The budget includes provisions that would remove access to health coverage and food assistance for individuals with humanitarian protections, such as refugees and asylum seekers. Please do not sit back and let our fellow North Carolinians lose health care insurance. Fix this egregious situation.