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North Carolina Governor Josh Stein Advocates for House Bill 491 to Safeguard Medicaid Amid Funding Crisis

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Published on October 22, 2025
North Carolina Governor Josh Stein Advocates for House Bill 491 to Safeguard Medicaid Amid Funding CrisisSource: Wikipedia/NCDOTcommunications, CC BY 2.0, via Wikimedia Commons

In the ongoing debate over Medicaid funding in North Carolina, Governor Josh Stein supports House Bill 491, which proposes transferring $190 million from the Medicaid Contingency Reserve to the state's Medicaid program. The bill aims to prevent upcoming provider rate cuts and maintain health care services for Medicaid recipients. The Governer stated in a press release, "The House has now acted on two clean Medicaid funding bills, and the Senate has left town without even considering this bill."

Provider rate cuts took effect on October 1, increasing the need for legislative action. House Bill 491 provides partial funding intended to allow time to develop a longer-term solution to the Medicaid budget gap. The Senate adjourned without considering the bill, leaving its passage uncertain. The Governor has requested that the Senate return to Raleigh to address the matter for Medicaid recipients.

During this week’s NC Strong Update, Governor Stein highlighted the impact of the issue on North Carolinians. According to the Office of the Governor, he urged the General Assembly to reach an agreement and pass a clean bill that provides the full $319 million needed to fund Medicaid.

In a letter sent last week to legislative leaders, Governor Stein outlined three options to reverse the Medicaid cuts, including using funds from the Medicaid Contingency Reserve. As the legislative stalemate continues, many beneficiaries await a resolution to maintain uninterrupted access to essential health services. The Governor noted that the legislature has had months to address the issue, emphasizing the need to reduce the strain on Medicaid’s budget and those who rely on the program.