As North Carolina Governor Josh Stein warns of devastating impacts from proposed federal cuts to Medicaid and SNAP, U.S. Senator Thom Tillis is doubling down—pushing for further reductions to key health care programs, including Medicare, according to WCNC.
Governor Stein, in a letter to Senators Thom Tillis and Ted Budd, urged them to reject the House’s sweeping reconciliation bill, which includes nearly $900 billion in cuts to Medicaid and provisions that could destabilize health care access for hundreds of thousands of North Carolinians.
According to Gov. Stein’s office, nearly 255,000 residents are at risk of losing Medicaid coverage, and an estimated 470,000 could become uninsured if marketplace subsidies expire at the end of 2025. Additionally, the bill threatens enhanced federal Medicaid funding that currently supports the state’s Medicaid expansion for more than 650,000 people.
“Medicaid and SNAP improve the health and well-being of hundreds of thousands of North Carolinians, support our economy, and provide critical support to local governments, hospitals, farmers, and grocers,” Gov. Stein wrote in a press release. “North Carolina has taken bipartisan steps to strengthen our health system and protect working families. I urge the Senate to continue that progress by opposing these unprecedented cuts to SNAP and Medicaid that would leave North Carolinians, especially those in rural communities, without food assistance and health care.”
Yet while Stein is sounding the alarm, Tillis is advocating for even broader cuts—this time targeting Medicare. In a recent interview with HuffPost, the Republican senator said he believes efficiency measures used in the Medicaid overhaul should be applied to Medicare as well.
“These are billions and billions and billions of dollars spent every year. If we get 10, 15% efficiency out of that, that’s a big number,” Tillis said.
Tillis’ office later clarified that the senator is supporting legislation focused specifically on eliminating “waste, fraud, and abuse” in the Medicare Advantage program, claiming that the changes would not impact beneficiaries. However, critics remain skeptical, including former Democratic Congressman Wiley Nickel, who pushed back.
“Certainly waste, fraud and abuse, that’s part of any government program, but it’s a small amount,” Nickel said. “Ten to 15%, you’re just taking away health care.”
Nickel added that the bill would create unnecessary hurdles for families and seniors trying to access care. “The whole design of what they’re doing in Congress right now is really horrible,” Nickel said. “It’s about putting up barrier after barrier for families and seniors. You know, for these programs, they want to make it so hard that people just won’t be able to get coverage.”
The U.S. House bill would also force North Carolina to absorb up to 25% of SNAP costs, requiring the state to come up with $700 million annually or slash essential nutrition support. Stein warned this would hurt local economies, especially in rural counties already struggling with limited resources. SNAP contributes $2.8 billion annually to North Carolina’s economy.
Meanwhile, Republicans, including Tillis, are working to finalize the legislation with the goal of sending it to President Trump’s desk by July 4th. Despite claims that they are looking for ways to reduce the federal deficit without cutting benefits, the nonpartisan Congressional Budget Office estimates the current package would add $2.4 trillion to the national debt over the next decade.
As the 2026 Senate race begins to take shape, Tillis faces declared primary challengers on the right, while Democrats are watching closely. In addition to Nickel, former Governor Roy Cooper is reportedly considering a run, though he has not made a formal announcement. In the meantime, Governor Stein continues to elevate the stakes.
