Medicaid and SNAP benefits under fire after bill's passage

More than 7,800 Transylvania County residents will be impacted by major changes to Medicaid and SNAP benefits after President Trump’s One Big Beautiful Bill Act removed more than $1 trillion from the programs' future funding when it was passed earlier this month.

According to slides from a July 9 North Carolina General Assembly briefing obtained by Asheville Watchdog, North Carolina alone could lose up to $49.9 billion in Medicaid funding over the next 10 years as a result of the act and the Supplemental Nutrition Assistance Program could be eliminated if the state does not backfill funding cuts for the food-assistance program by the federal government.

According to the North Carolina Department of Health and Human Services, there are currently 7,835 Medicaid recipients in Transylvania County who rely on the federally funded and state-administered program for their health care coverage.

Those recipients account for 23% of the county’s population.

Of those receiving the benefits, 1,886 in the county are N.C. Medicaid Expansion recipients between the ages of 19-64 who qualify for the program based on expanded eligibility guidelines dictated by the state.

According to the General Assembly briefing, the new rules and funding cuts stipulated in the OBBBA will cause an expected 255,000 Medicaid recipients in the state to lose coverage as administration costs and new requirements will limit the state’s ability to keep the program as expansive as it currently is.

Transylvania County Department of Social Services Director Amanda Vanderoef said the total effects of the changes on Medicaid recipients in Transylvania County are still unknown.

“We are waiting on the state who administers the funding to us to give guidance on expected impacts of the federal and state budgets,” she said.

New stipulations in the Medicaid program will require many participants to prove they have worked more than 80 hours in a month to continue receiving the benefits, a rule that was not in place before.

Medicaid benefits will also be required to be reviewed by the state every six months instead of the annual review previously required.

According to the General Assembly briefing, both of these changes mean the program will incur much larger administration costs as state workers will need to keep track of employment records for Medicaid recipients and perform twice as many Medicaid reviews each year.

SNAP BENEFITS

According to Vanderoef, 1,665 Transylvania County residents rely on SNAP benefits to supplement their grocery spending.

The briefing from the General Assembly warns that if the state does not step up to pay a possible $420 million deficit in the program’s funding imposed by the federal government the benefit could disappear in the state in the next two years.

Currently the federal government pays for 100% of the program, but the new guidelines for the program stipulate graduations of state contributions which are tied to the error rates states measure in administering the program.

According to the briefing, the average error rate for SNAP for all states in 2024 was 10.93%. North Carolina’s error rate of 10.21% under the new “benefit cost share” scheme would mean the General Assembly would have to figure out how to make up a $420 million gap in funding if it wished to continue the program in the state.

The briefing said the lowest error rate graduation of less than 6% was only met by eight states in 2024, meaning the vast majority of states in the U.S. would have to start contributing to the social welfare program which they had never previously needed to.

The changes in SNAP, according to the slides, also extend to administration of the program as the federal government will pass on 75% of the administrative costs for the program to state and county governments.

The briefing estimates administrative costs for the state to go up by $14 million and costs spread across all 100 counties to go up $65 million.

If the General Assembly decides to supplement the funding of the program, the slides said, a estimated 90,000 adults in North Carolina could still lose SNAP benefits due to a new work requirement for recipients between the age of 18-64 and parents of children over the age of 14.