(The Center Square) – Medicaid is slated for $1 billion, SNAP for $5.3 million, and a new children’s hospital in the Triangle for $208.5 million in North Carolina’s $34.4 billion state budget.
More than $9.3 billion is divvied into various areas of the state Department of Health and Human Services. The spending plan, approved by lawmakers on Thursday, is awaiting action by first-term Democratic Gov. Josh Stein.
If Stein signs the state budget into law, it’ll be the first signed by a North Carolina governor since Nov. 18, 2021, and only the second since Sept. 18, 2015.
Medicaid has long been a contentious battle between Republicans and Democrats. It was the desired signature of former Gov. Roy Cooper, now a U.S. Senate candidate, and finally achieved in 2023 in a budget battle negotiation that in part brought the state universal school choice.
In April, ahead of the June 30 end of the fiscal year, lawmakers provided a $319 million rebase in the Health Care Practitioner Transparency Act. House Speaker Destin Hall, R-Caldwell, said the legislation addressed Stein’s administration letting “costs run wild.”
Medicaid rebase means an adjustment to fiscal support because of costs and or volume of people enrolled. First-term Republican state Auditor Dave Boliek’s office is probing the program for potential fraud, particularly in the area of autism therapy.
The Supplemental Nutrition Assistance Program, in accordance with federal legislation in the One Big Beautiful Bill Act, will implement changes. The law addressed rules on able-bodied adults without dependents; work requirements for ages 55-64; dependent exemptions; changed vulnerable group exemptions; and tightened some local waivers.
North Carolina’s share of the federal SNAP benefits program is about $2.8 billion. The state is dealing with an error rate exceeding the national floor standard and possible payment of penalties in 2028 of more than one-quarter of a billion dollars.
The appropriations bill releases $208.5 million for the North Carolina Children’s Hospital from the ARPA Temporary Savings Reserve. NC Children’s will be built on about 230 acres at the intersection of U.S. 1 and N.C. 540 in a partnership of UNC Health and Duke Health.
The 500-bed children’s hospital will also be home to a children’s outpatient care center; 103 children and adolescent behavioral health beds; and research and education initiatives by both universities’ schools of medicine.
Mental health, development disabilities and substance use services will get more than $816 million.
In the Health Department, 362 vacant positions will be eliminated providing a $35 million savings.
The budget language changes sales tax reimbursements that allowed large hospitals and their affiliates to be a single entity.
