Rep. Pierce files Medicaid funding bill in North Carolina House

A new bill filed by State Rep. Garland E. Pierce in the North Carolina House aims to boost Medicaid funding and strengthen program stability for families and children, according to the North Carolina State House.

The bill, filed as HB 1141 on April 29 during the 2025 regular session, was formally listed with the short title: ‘Protecting Medicaid & Autism Services.’

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, this bill increases recurring General Fund appropriations for Medicaid by $319 million beginning in the 2025-26 fiscal year and $728 million beginning in the 2026-27 fiscal year to rebase the program for enrollment, cost and federal match changes, including launch of the Children and Families Specialty Plan; this funding is retroactive to July 1, 2025. The bill allows Medicaid prepaid health plans to operate closed provider networks specifically for research-based behavioral health treatment and requires the children and families specialty plan to use closed networks for certain intensive behavioral health and residential services. It also repeals statutory triggers that would discontinue Medicaid expansion coverage, aiming to promote program stability. Except as otherwise stated, the bill takes effect when it becomes law.

Of the four sponsors of this bill, Zack Hawkins proposed the most bills (57) during the 2025 regular session.

Bills in North Carolina follow a multi-step process before becoming law. A lawmaker starts by filing a bill, which is assigned to a committee for review. The bill must be read three times in each chamber. If one chamber changes the bill after the other passes it, both must agree on the final version. Once both chambers approve the same bill, it goes to the governor, who has 10 days (or 30 if the legislature is not in session) to sign, veto, or let it become law without a signature.

You can read more about the bills and other measures here.

Pierce graduated from Fayetteville State University with a BS.

Pierce, a Democrat, was elected to the North Carolina State House in 2005 to represent the state’s 48th House district, replacing previous state representative Donald Bonner.