Across the country, health care is in crisis thanks to Donald Trump and Congressional Republicans – including in North Carolina, where Trump attempted to gaslight Tar Heel voters about the crisis he has created and exacerbated. North Carolinians who buy insurance on their own will see their premiums and out-of-pocket costs skyrocket beginning in 2026, when North Carolina premiums will increase by an average of 29 percent and hundreds of thousands will lose coverage altogether after Trump and Republicans made the largest cut to health care in history. Their Big, Ugly Bill slashed over $1 trillion from Medicaid and the Affordable Care Act (ACA) in order to fund tax breaks for billionaires and big corporations. As Republicans’ devastating cuts to Medicaid begin to take effect, rural hospitals across the state will shut down, seniors will be forced out of their nursing homes, and people fighting cancer or addiction will lose life-saving care. Trump and Republicans have put health care at risk for nearly one million North Carolinians and thrown our entire health care system into chaos.
BY THE NUMBERS
- Nearly one million North Carolinians will see their health insurance costs skyrocket an an average of 149 percent after Trump and Republicans ripped away the tax credits that made coverage affordable:
- A 45-year-old in North Carolina making $64,000 a year will see their average annual premium costs rise by $3,210 to hit $8,650 annually.
- A 60-year-old couple in North Carolina making $85,000 a year will see their average annual premium costs rise by $25,292 to hit $32,517 annually.
- A family of four in North Carolina making $130,000 a year will see their average annual premium costs rise by $13,428 to hit $24,478 annually.
- Around 36,000 North Carolinians are expected to lose their health care coverage entirely thanks to ACA premium increases, and 450,000 North Carolinians overall will have their coverage ripped away and go uninsured due to the Trump-GOP health care cuts.
- Trump and Republicans cut $13.4 billion in critical funding for North Carolina hospitals. 14 facilities across the state are newly at-risk or have announced cuts since Trump and Republicans passed their Big, Ugly Bill, including:
- UNC Rockingham Hospital
- Person Memorial Hospital
- UNC Health Chatham
- Angel Medical Center
- Blue Ridge Regional Hospital
- Martin General Hospital
- Minnie Jones Health Center
- Hominy Valley Health Center
- McDowell Health Center
- ECU Health
- UNC Health Lenoir
- CarolinaEast Medical Center
- Scotland Health
- Carolina House
- 91 percent of North Carolina voters do not support cuts to Medicaid.
- Republicans created at least a $29 billion hole in the North Carolina state budget over the next ten years to pay for tax breaks for the wealthy and corporations.
- Republican cuts to Medicaid will result in 30,800 North Carolina jobs lost alongside a $5.2 billion loss in state economic output as well as a $3 billion state GDP loss.
Key Points: The GOP War on Health Care
Republicans Ripped Away Tax Credits, Hiking Premiums for Over 20 Million Americans. Without these tax credits, families who buy insurance on their own through the ACA will see their costs double, triple, and even quadruple. Over four million will lose their coverage entirely because Republicans made it unaffordable, including middle-class families, small business owners, and rural residents.
Millions of Low-Income Americans, Mostly in Trump-Voting States, Will Go From Paying $0 a Month to Hundreds or Thousands for Health Coverage. Last year, millions of families who were struggling to get by, making as little as $32,000 a year but not eligible for Medicaid, were able to get health insurance thanks to the enhanced premium tax credits. This year, over 10.9 million of these low-income Americans will see their premiums go from $0 a month to hundreds or thousands each month because of Trump and Republicans in Congress – a price many won’t be able to afford. 92 percent of these Americans live in states that voted for Trump and largely reside in states that refuse to expand Medicaid.
Republicans Gutted Federal Funding for Medicaid, Slashing Benefits and Kicking People off Coverage to Fund Tax Cuts for the Rich. Currently, the federal government pays between 50 percent and 77 percent of enrollees’ Medicaid costs, and more for certain high-value services. The Republican tax bill slashed nearly a trillion dollars in federal funding from Medicaid, which will strain state budgets and leave millions of people uninsured over the next ten years.
Republicans Cut the Lifeline That Keeps Rural Hospitals Open. Medicaid helps fund rural hospitals by ensuring more patients can pay for their care. Rural hospitals in Medicaid expansion states are 62 percent less likely to close. Republicans’ cuts to Medicaid leave rural hospitals, clinics, and nursing homes in peril, with over 600 facilities now at-risk of closure.
Republicans’ Big Ugly Bill Decimates Access to Essential Services Like Maternity Care and Long-Term Care. Medicaid is the single largest payer for long-term care, maternity care, and mental health services. Nearly a third of adults have received maternity care, home health care, or nursing home care through Medicaid. Nearly one in five adults struggling with mental illness have access to care through Medicaid. Republicans’ Medicaid cuts will leave Americans with disabilities in need of long-term care, new mothers and infants, and those suffering from mental health issues at risk for loss of coverage, limited access to care, and creating economic instability in families.
Republicans Throw Millions off Their Coverage by Adding Burdensome Work Reporting Requirements to Medicaid. Republicans’ bill requires those enrolled in Medicaid without a work exemption to prove that they are working, doing community service, receiving work training, or enrolled in school part time. Research shows that work reporting requirements cost states money and do not improve people’s ability to find work. In Georgia, a GOP alternative to Medicaid expansion emphasizing work requirements cost taxpayers $26 million, only provided coverage to 3,500 people, and resulted in consulting firms pocketing 90 percent of the funding. Work requirements will cost an estimated 5 million Americans their Medicaid coverage and are only being adopted to pay for tax breaks for billionaires and corporations.
Republicans Are Making It Harder to Enroll and Obtain Health Coverage. Republicans are not only making it harder for families to enroll in coverage by shortening the enrollment period and taking away low-income families’ ability to sign up for coverage outside of the six-week enrollment period, but they are also making it difficult to stay enrolled by establishing more paperwork burdens for enrolling and proving eligibility for tax credits. These policies will end with millions of Americans unable to access the coverage that they need to stay healthy.
Republicans Will Penalize Families With Unexpected Changes in Income. Under the Trump-GOP bill, if low-income families experience a change in their circumstances, such as a promotion or a new job, they could be penalized with thousands of dollars in additional payments around tax time. These repayments will be devastating for freelancers, gig workers, and small business owners, who make up a large share of marketplace enrollees.