600k+ in NC could lose health insurance after Trump’s ‘Big, Beautiful Bill’

WILMINGTON, NC (WWAY) — According to the North Carolina Department of Health and Human Services, out of the 11 million people that live in the state, 2.9 million are insured under Medicaid.

But many recipients could be at risk after President Donald Trump’s so-called “Big, Beautiful Bill” slashed federal Medicaid funding.  

Hollis Smith is the deputy director of the NC Navigator Consortium—an organization that helps people find which health care plans they qualify for.

She says two provisions in particular could leave thousands in North Carolina without coverage—a work requirement for Medicaid recipients, and a provider tax cap.  

“The combination of the two will place a financial strain on our state’s Medicaid program, that would trigger our Medicaid expansion rollback law, meaning that 670,000 North Carolinians that currently receive health coverage through expansion would no longer have access to that coverage,” Smith explained. 

The work requirement provision requires those between the ages of 18 and 64 to prove every six months that they’re working more than 80 hours a month. 

Though, a concern among many is that it could create a catch-22 for many recipients who need healthcare to work.  

“Individuals who are maybe in rural areas and don’t have access to transportation and are also out of work because of a health condition. For them, the key to getting back to work is being able to access the health they need,” Smith noted. 

Smith says the bill will likely mean a loss of coverage that was life changing for so many. 

“Many of the individuals who qualify for Medicaid under expansion has been uninsured for years, or decades prior to expansion passing because they simply did not have access to an affordable health coverage option. So, these are individuals who, after years, are finally able to access mental and behavioral health services, or get that surgery they’ve been needing for a long time.” 

It’s possible the state could step in to fill some of the federal funding gap, but Smith says they have not received any indication that the General Assembly will act. 

If you or someone you know has questions about how the bill affects your coverage, NC Navigator is ready to help. You can contact the organization by visiting ncnavigator.org, or by calling (855) 733-3711.