North Carolina 2025-2026 Regular Session

North Carolina Senate Bill S403

Introduced
3/24/25  
Refer
3/25/25  
Refer
3/25/25  
Report Pass
4/10/25  
Refer
4/10/25  
Report Pass
4/29/25  
Engrossed
5/1/25  
Refer
5/5/25  

Caption

Additional Medicaid Funds and Requirements

Impact

If enacted, SB 403 will directly impact funding strategies for the Department of Health and Human Services (DHHS), reallocating significant funds away from public health support, particularly in Medicaid. Consequently, there will be a reduction of approximately $34 million in recurring Medicaid funds. The bill's objection to eliminate positions is expected to produce significant savings of around $19 million across state agencies. The reduction in funding to the Future Building Reserves and the State Capital and Infrastructure Fund will also be felt, with over $42 million diverted from these initiatives, potentially impacting future state infrastructure projects.

Summary

Senate Bill 403, titled 'Additional Medicaid Funds and Requirements', seeks to adjust Medicaid funding to reflect anticipated changes in healthcare costs, while also addressing various state budget elements such as reducing funding for vacant positions across state agencies and capital reserves. This legislation includes provisions for cuts in the Medicaid program, notably discontinuing coverage for certain obesity management medications beginning October 1, 2025. The bill aims to streamline funding within state healthcare provisions and improve the efficiency of Medicaid eligibility administration by eliminating unnecessary vacancies in state agencies involved in these processes.

Sentiment

The sentiment surrounding Senate Bill 403 appears mixed. Supporters, particularly among conservative legislators, argue that it is a necessary move to control state spending and ensure the sustainability of Medicaid funding amidst rising healthcare costs. Advocates contend that eliminating vacancies will create a more efficient administrative process for Medicaid eligibility. Conversely, critics express concern that the cuts to Medicaid and infrastructure funds may leave vulnerable populations without essential support while jeopardizing future capital investments crucial for growth and public service delivery.

Contention

Key points of contention include the decision to eliminate Medicaid coverage for obesity management medications and the general austerity measures that the bill supports. Opponents argue that these cuts will strain resources for those needing assistance with obesity-related health issues, potentially leading to negative health outcomes. The bill proposes significant changes to the operational structures of the DHHS and county departments, particularly the temporary assumption of Medicaid eligibility responsibilities by the state in cases of failure to comply with accuracy and timeliness standards, raising concerns over local governance and accountability.

Companion Bills

NC H491

Same As Medicaid Work Requirements

Previously Filed As

NC H259

2023 Appropriations Act

NC H317

Adjustments to the 2023 Appropriations Act

NC H430

Governor's Budget

NC H1010

Modernize Certain Medicaid Provider Rates

NC H1003

Jt Caucus for IDD/Omnibus

NC S508

2023 Budget Tech/Other Corrections

NC S383

Protect Our Youth in Foster Care

NC H860

Protect Our Youth in Foster Care

NC H10

Require ICE Cooperation & Budget Adjustments

NC H476

Increase Personal Needs Allowance/Medicaid

Similar Bills

NC H76

Access to Healthcare Options

KY HB7

AN ACT relating to welfare and family services.

NC H562

Healthcare Investment Act

LA HB480

Provides relative to Medicaid fraud detection and prevention (RE INCREASE GF EX See Note)

LA HB2

Provides for Medicaid eligibility determination functions and Medicaid fraud detection and prevention (Items #14 and 15) (EG INCREASE GF EX See Note)

LA HB5

Provides for Medicaid eligibility determination functions and Medicaid fraud detection and prevention (Items #14 and 15)

LA SB7

Provides relative to Medicaid eligibility determination functions and Medicaid fraud detection and prevention. (Item #14 and Item #15) (gov sig)

SC S0342

Pharmacy services