North Carolina House receives bill from Rep. Pierce to bolster Medicaid funding

Rep. Garland E. Pierce has put forward a new measure in the North Carolina House designed to raise Medicaid funding and support stronger long-term stability for families and children, according to the North Carolina State House.

Filed as HB 1141 on April 29 during the 2025 regular session, the initiative carries the short title ‘Protecting Medicaid & Autism Services.’

Below, we provide a summary of key provisions using the actual bill text and, where needed, include clarifications for understanding.

The bill directs additional recurring General Fund appropriations for Medicaid, increasing funding by $319 million as of the 2025-26 fiscal year and $728 million beginning in the 2026-27 fiscal year, with adjustments based on enrollment, costs and shifts in federal match—plus launch of the Children and Families Specialty Plan; this funding will be retroactive to July 1, 2025. Medicaid prepaid health plans are permitted to maintain closed provider networks for research-based behavioral health treatments, and closed networks are also required for intensive behavioral health and residential services associated with the children and families specialty plan. It eliminates previous statutory conditions that could end Medicaid expansion coverage, seeking to stabilize the program. Unless otherwise indicated, the measure takes effect upon becoming law.

Among the bill’s four sponsors, Zack Hawkins introduced the highest number of measures, proposing 57 during the 2025 regular session.

In North Carolina, bills must go through a multi-stage process before becoming law. The process begins when a legislator files a bill, which is reviewed by committee. Passage requires three separate readings in each chamber, and any amendments made by one body require concurrence by the other. After identical approval, the bill is sent to the governor, who has 10 days (or 30 if the assembly is not in session) to sign, veto or allow it to become law without action.

Further information about this and other recent bills is available here.

Pierce holds a BS degree from Fayetteville State University.

Rep. Pierce, a Democrat, began serving in the North Carolina State House in 2005 as the representative for the 48th House district, following Donald Bonner’s tenure.