GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 653
Short Title: Adjust FMAP Trigger for Medicaid Expansion. (Public)
Sponsors: Representatives Greenfield, Pittman, R. Pierce, and Willingham (Primary
Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Rules, Calendar, and Operations of the House
April 2, 2025
*H653 -v-1*
A BILL TO BE ENTITLED 1
AN ACT TO LOWER THE THRESHOLD AT WHICH A REDUCTION OF THE FEDERAL 2
MEDICAL ASSISTANCE P ERCENTAGE TRIGGERS D ISCONTINUATION OF 3
COVERAGE FOR THE MED ICAID EXPANSION POPULATION. 4
The General Assembly of North Carolina enacts: 5
SECTION 1. G.S. 108A-54.3C reads as rewritten: 6
"§ 108A-54.3C. NC Health Works federal financial participation. 7
(a) As used in this section, the term "newly eligible individual" has the same meaning as 8
in 42 C.F.R. § 433.204. 9
(b) If the federal medical assistance percentage for Medicaid coverage provided to the 10
category of individuals described G.S. 108A-54.3A(a)(24) newly eligible individuals falls below 11
ninety percent (90%) the federal medical assistance percentage for Medicaid coverage provided 12
to individuals who are not newly eligible individuals, then Medicaid coverage for this category 13
of the individuals described in G.S. 108A-54.3A(a)(24) shall be discontinued as expeditiously as 14
possible but no earlier than the date the lower federal medical assistance percentage takes effect. 15
Upon receipt of information indicating that the federal medical assistance percentage for 16
Medicaid coverage provided to newly eligible individuals will be lower than ninety percent 17
(90%), the federal medical assistance percentage for Medicaid coverage provided to individuals 18
who are not newly eligible individuals, the Secretary shall promptly do all of the following: 19
(1) Notify the Joint Legislative Oversight Committee on Medicaid, the Office of 20
State Budget and Management, and the Fiscal Research Division of the 21
determination and post this notice on the Department's website. The notice 22
must include the proposed effective date of the discontinuation of coverage. 23
(2) Submit all documents to the Centers for Medicare and Medicaid Services 24
necessary to discontinue Medicaid coverage for the category of individuals 25
described in G.S. 108A-54.3A(a)(24)." 26
SECTION 2. This act is effective when it becomes law. 27