Faith and community leaders crowded into the General Assembly on Tuesday, urging lawmakers to move quickly on fixes to House Bill 696, the emergency Medicaid measure Gov. Josh Stein signed in late April. They argue that technical language tucked into the law could hike costs for patients and strip coverage from thousands of lawfully residing immigrants, and they handed legislative staff a letter asking leaders to correct the provisions before state agencies lock in how the law will work on the ground.
Gov. Josh Stein signed House Bill 696 on April 30, providing about $319 million from the state's Medicaid contingency reserve to keep the program solvent and protect provider payments, according to the Governor's Office. Supporters say the money is meant to prevent provider-payment disruptions while lawmakers and state officials work through policy changes in the 33-page measure.
Faith Leaders Deliver Letter at the Capitol
About 15 people, faith leaders and congregants from across North Carolina, gathered at the Legislative Building and delivered a letter to staff for Senate leader Phil Berger and House Speaker Destin Hall calling for fast-track amendments. The letter was signed by more than 348 faith leaders and community members, organizers said. “HB 696 was necessary to extend Medicaid, but there were these, I think, inadvertent little glitches in the bill,” Jane Foy, a retired pediatrician, told The News & Observer.
Who Would Be Hit
Advocates and state health officials say the law’s immigration language could end Medicaid coverage for about 27,000 lawfully residing immigrants, a group that WUNC reported includes roughly 26,500 children and about 500 pregnant people, and those changes are set to take effect Oct. 1, 2026. Advocates warn that losing prenatal and pediatric coverage would shift costs to counties and strain rural providers, complicating care in already underserved areas.
Work Rules and Timing
HB 696 also directs the Department of Health and Human Services to put federal community engagement requirements in place and adds more frequent eligibility checks, including a three-month lookback for applicants, changes that are spelled out in the law. The Centers for Medicare & Medicaid Services has issued an interim final rule that requires states to implement work or community engagement requirements no later than Jan. 1, 2027, which frames the state’s implementation timeline.
Advocates Warn of Paperwork Barriers
Patient groups, providers and faith leaders say higher cost-sharing, longer verification windows and monthly data checks will create administrative traps that push people out of care, especially those with irregular schedules or limited access to county offices. “It would be impossible,” one attendee said of the three-month lookback, and retired hospital administrator Robert Jones warned counties could end up footing prenatal care bills, as reported by The News & Observer. The fear, they say, is less fraud control and more red tape that quietly knocks eligible people off the rolls.
What Could Change
Organizers say they will keep pressing for corrections while agencies prepare implementation steps, and lawmakers have signaled they are open to fixes through follow-up legislation or the short-session budget. Gov. Stein and some negotiators have indicated a willingness to address unintended effects, a stance advocates hope will translate into a cleanup bill that prevents coverage gaps, according to reporting from WUNC.
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