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Read. Follow. Verify.North Carolina directs DHB to seek federal approval for Medicaid personal care coverage in adult care homes
Last action · May 27, 2025: Re-ref to Health Care. If fav, re-ref to Finance. If fav, re-ref to Rules and Operations of the Senate (Senate action)Sponsors: John Sauls and 30 others
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What This Bill Would Do
The North Carolina General Assembly requires the Department of Health and Human Services to ask federal officials for permission to extend Medicaid personal care services to certain adult care home residents whose incomes exceed current assistance limits. Under the measure, the requested coverage applies to individuals with incomes up to 180% or 200% of the , provided the expansion is offset by savings or and approved by the federal Centers for Medicare and Medicaid Services.
Residents in licensed adult care homes with incomes above the State-County Special Assistance threshold may gain access to Medicaid personal care coverage if federal approval is granted and financial offsets are met.
Who It Would Affect
Groups the bill's text would affect if enacted, as described in the record. Being affected is not a position for or against it.
Individuals who reside in licensed adult care homes and special care units
Their eligibility criteria for Medicaid coverage of personal care services are altered based on federal approval and income thresholds.
Department of Health and Human Services, Division of Health Benefits
The agency is tasked with consulting stakeholders, preparing the federal request, submitting it within 90 days, and managing implementation.
Key Facts
- The Division of Health Benefits must submit a request to the Centers for Medicare and Medicaid Services within 90 days of the act becoming law.
- The requested Medicaid coverage applies to individuals in licensed adult care homes and special care units whose incomes exceed current State-County Special Assistance limits.
- Income caps for the requested coverage are set at up to 180% of the federal poverty level for basic rate qualifications, and up to 200% for enhanced rate qualifications.
- Any new Medicaid coverage requested must be fully offset by savings or cost avoidance.
Show all 6 facts
- Implementation of the new coverage depends entirely on receiving approval from the federal Centers for Medicare and Medicaid Services and meeting all statutory goals.
- The act takes effect immediately upon becoming law.
Frequently Asked Questions
Who is eligible for the proposed Medicaid personal care services coverage under this bill?
What must happen before this expanded coverage goes into effect?
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News Coverage
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Votes, people, money & the original sourceWhere This Stands
Currently passed chamber. The next step in the legislative lifecycle is Law.
Procedural history
18 actions- May 27, 2025SenateRe-ref to Health Care. If fav, re-ref to Finance. If fav, re-ref to Rules and Operations of the Senate
- May 27, 2025SenateWithdrawn From Com
- Apr 28, 2025SenateRef To Com On Rules and Operations of the Senate
- Apr 28, 2025SenatePassed 1st Reading
- Apr 28, 2025SenateRegular Message Received From House
- Apr 17, 2025HouseRegular Message Sent To Senate
Show 12 earlier actions
- Apr 16, 2025HousePassed 3rd Reading
- Apr 16, 2025HousePassed 2nd Reading
- Apr 15, 2025HousePlaced On Cal For 04/16/2025
- Apr 15, 2025HouseCal Pursuant Rule 36(b)
- Apr 15, 2025HouseReptd Fav
- Apr 15, 2025HouseRe-ref Com On Rules, Calendar, and Operations of the House
- Apr 15, 2025HouseReptd Fav
- Apr 8, 2025HouseRe-ref Com On Judiciary 1
- Apr 8, 2025HouseReptd Fav
- Mar 25, 2025HouseRef to the Com on Health, if favorable, Judiciary 1, if favorable, Rules, Calendar, and Operations of the House
- Mar 25, 2025HousePassed 1st Reading
- Mar 24, 2025HouseIntroducedFiled
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Sponsors
Show 26 more sponsors
Connected Entities
Sources
www.ncleg.gov
Analysis Score
0–100- Significance60How much this matters to a regular citizen
- Controversy25Intensity of disagreement among stakeholders
- Entertainment5Compellingness for a non-policy-wonk reader
- Buzz30Current news / social attention level
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