Greg Murphy, a representative from North Carolina, said that Democratic Medicaid expansions strain resources and praised Republican reforms in the One Big Beautiful Bill as measures to safeguard vulnerable patients and preserve the program. This statement was made on X.
“Democrats expanded Medicaid eligibility far beyond the program’s original intent, straining federal resources for individuals who actually need assistance the most,” said Gregory Francis Murphy, U.S. Representative for North Carolina’s 3rd congressional District (R). “In the OBBB Act, Republicans enacted reforms and solutions to protect vulnerable patients and preserve the program for future generations.”
The One Big Beautiful Bill Act (OBBB Act), signed into law in 2025, has significantly reshaped healthcare by reducing Medicaid spending while establishing a $50 billion Rural Health Transformation Program. This initiative aims to deliver $10 billion annually through 2030 to stabilize struggling hospitals. According to Holland & Knight, states are required to submit plans to the Centers for Medicare & Medicaid Services (CMS) this year to access these funds, which are intended to support access, technology, and care delivery in rural communities even as broader Medicaid reductions loom.
Medicaid and the Children’s Health Insurance Program (CHIP) enrollment stood at approximately 78.4 million people in early 2025, with children comprising nearly half of all beneficiaries. CMS data indicates that federal Medicaid spending reached $871.7 billion in 2023, marking a 7.9% increase from the previous year. While states anticipate slower spending growth in fiscal year 2025 due to enrollment unwinding, the program remains one of the largest federal expenditures.
Rural hospitals continue to face severe financial challenges, with 146 closures between 2010 and 2023, including 81 complete shutdowns. More than 193 closures have occurred since 2005 overall. According to the UNC Sheps Center and KFF, over 700 rural hospitals—about one-third of all such facilities—are currently at risk of closing, raising concerns about access to healthcare in underserved regions.
Murphy has been representing North Carolina’s 3rd District since 2019 and is noted as the only practicing surgeon in Congress. He holds an MD from UNC Chapel Hill and co-chairs both the Republican Doctors Caucus and the Academic Medicine Caucus. His official House biography highlights his focus on issues such as veterans’ health, opioid reform, and conservative healthcare policy during his tenure.
North Carolina faces significant healthcare challenges with about 39% of Medicaid enrollees residing in rural areas that heavily depend on vulnerable hospitals. According to North Carolina Health News, proposed federal Medicaid cuts could cost the state’s rural hospitals $3.7 billion over the next decade. The OBBB Act’s rural health fund may cover only half of those projected losses, underscoring the fragility of the state’s hospital network.
