The Big Budget Bill’s Impact on North Carolina’s Health System: More North Carolina Residents Uninsured, Higher Health Care Costs, and More Consequences of the Many Cuts to Care   - Families USA Skip to Main Content
06.18.2025 / Press Release

The Big Budget Bill’s Impact on North Carolina’s Health System: More North Carolina Residents Uninsured, Higher Health Care Costs, and More Consequences of the Many Cuts to Care  

New Families USA Analysis Details How Steep Cuts Will Hurt North Carolina Residents

RALEIGH, NC – A new fact sheet from Families USA details how the pending budget bill, set to be voted on by the Senate in the next week or so, will harm North Carolina’s health system, including cutting off coverage for at least 520,000 North Carolinians, making it harder for people to get and maintain coverage, and taking away crucial patient protections for children. The bill also drives up costs for those buying insurance through the Marketplace, skyrocketing premiums and increasing out-of-pocket costs while taking away crucial premium tax credits.

“The cuts to Medicaid and the ACA will have devastating and dramatic impacts on health coverage, care, and costs for American families, and in many ways, especially in North Carolina. The cuts will not just mean that tens of thousands of North Carolina residents lose coverage, but federal cuts will force state budgets into crisis, forcing states to drastically scale back services, leading to closures of rural hospitals and community clinics,” said Anthony Wright, executive director of Families USA. “Senator Tillis must stand up to the party bosses and the billionaires who want more tax cuts and side with patients and health providers and plans who oppose this bill that harms access and affordability of health care for so many North Carolina working families.”

The proposed cuts are in opposition with the voters when 82% of adults nationwide — including 67% of Republicans want Congress to maintain or increase Medicaid spending.

The Medicaid program, NC Medicaid, covers 3,106,000 children and adults, including:

  • 1 in 4 North Carolina residents.
  • 1,430,000 children — 61% of all children in North Carolina.
  • 596,000 seniors and people with disabilities.

Marketplace coverage, available for individuals and families who do not qualify for NC Medicaid but also do not have employer-sponsored coverage, serves:

  • 975,000 North Carolina residents.
  • 73,000 small business owners in North Carolina and over 111,000 self-employed North Carolina residents.
  • About 96% of enrollees in the state who received an advanced premium tax credit to help them pay their premium.

Families USA, the longtime health consumer advocate, is organizing with groups in North Carolina and across the nation to protect against cuts care cuts that would force Americans to face increased costs and the loss of health coverage. The Families USA website has a plethora of materials on how its partners are working to defend Medicaid, and has facts sheets on the overall importance of Medicaid to people, the economy, and the health care system, how work reporting requirements would undermine access to Medicaid, and how cuts harm families and communities.