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N.C. Medicaid expansion could be repealed if federal funding for the program is cut

The "Medicaid Drug Decisions Transparency Act" would require pharmaceutical companies to disclose their payments to pharmacists and others who serve on state Medicaid drug boards — the advisory groups that decide which drugs Medicaid will and won't cover.
Gary Waters
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Ikon Images/Getty Images

State lawmakers are discussing what might happen to Medicaid expansion in North Carolina if the federal government cuts funding for the healthcare program.

Since President Donald Trump took office, there's been talk in Washington about possible cuts to the Medicaid program, although no specific proposal has been announced.

Any changes could have big ripple effects for North Carolina, where about 600,000 people gained access to Medicaid through legislation in 2023. That law includes a provision that would repeal Medicaid expansion if the federal government stops covering 90 percent of the cost.

Republican Senator Benton Sawrey co-chairs the Senate's healthcare committees, and said legislators are already talking about how to handle different hypothetical cuts.

"To keep that population in place, it would require a commitment, I think, from the state of several billion more dollars that we don't have," he said, "So we would have to have some tough conversations about what that would look like in case that federal share was reduced."