After a monthslong impasse, North Carolina’s Republican-led General Assembly approved $319 million in additional Medicaid funding, which was signed into law by Democratic Gov. Josh Stein. The funding closes a gap in the state’s request for $819 million in additional Medicaid costs, with $500 million having been approved in July 2025. The additional money helps support a program that provides health care benefits to more than 3 million low-income people statewide, including over 118,000 in Bladen, Columbus, Robeson, and Scotland counties.
North Carolina has the seventh-highest Medicaid enrollment in the country. Medicaid costs have risen sharply since 2020, when total expenditures were over $16.82 billion. In 2024, the state spent more than $27.7 billion, with the federal government providing more than $18.8 billion and the state providing over $8.91 billion. In Robeson County specifically, 66,000 residents are enrolled in Medicaid, representing about 57% of the total population and the eighth-highest enrollment across North Carolina’s 100 counties.
Restrictions and Implementation Challenges
The legislation includes provisions that restrict applied behavior analysis therapy for children with autism and developmental disorders, limiting telehealth use and requiring more services from specific providers. The law also requires stricter work requirements for Medicaid applicants—requiring three months of compliance before applying rather than the federal one-month lookback period most states plan to follow. Gov. Stein objected to provisions that will make North Carolina the 11th state not offering Medicaid to immigrant children and pregnant women who are legally in the United States but aren’t citizens, affecting nearly 27,000 pregnant women and children, including victims of human trafficking, green card holders, and refugees. The law also increases copayments for Medicaid expansion beneficiaries to the maximum allowed under federal law of $35 for certain services.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.robesonian.com/news/340376/what-the-medicaid-deal-means-for-the-border-belt