The NCMS Continues to Advocate on the Budget Reconciliation Process and the Impact of One Big Beautiful Bill on Medicaid
On Wednesday, June 4, 2025, the North Carolina Medical Society joined with a national coalition of state medical societies in sending a letter to Capitol Hill expressing concerns over the proposed cuts to Medicaid funding and coverage. The debate in Washington is over H.R.1 / “One Big Beautiful Bill”, which has passed the House and is now in the Senate.
The letter adds another exclamation point to our messages to Congress that the proposed cuts in Medicaid funding and coverage would be detrimental to our state. Our recent messaging to Capitol Hill has addressed multiple areas of concern . . .
Work requirements
Eligibility determination frequency
Medicaid Provider Taxes
Per capita caps on the expansion population
Federal Medical Assistance Program (FMAP)
Block grants
This week’s letter from the NCMS and its partner state associations specifically calls attention to the Provider Tax provisions in the pending package. Provider Taxes have been a long-standing and universally accepted means of sustaining state Medicaid programs in order that they can meet Medicaid patients’ care needs.
Some specific concerns for North Carolina related to the Provider Tax issue include:
- The provision in the budget reconciliation package that effectively freezes the amount or rate of existing provider taxes does not account for a formula-based approach that exists in North Carolina, as well as in some other states.
- Lowering or freezing the provider tax cap could result in cuts to programs, services and access to care.
- The provision will erode necessary funding to facilities, including rural hospitals and nursing homes, forcing them to reduce staffing, and subsequently impact quality of care and facility viability.
As the H.R.1 deliberations continue, we will continue to advocate for what is best for the health of 3.1 million North Carolinians who depend on Medicaid.