Congress Can Act Now Before SNAP Cost Shares Wreck State Budgets 

Jan 14, 2026

Position Title: Health Access Manager

Reports To: Executive Director

Status: Full-time, exempt

Location: North Carolina: hybrid/remote with statewide travel

Hiring Salary Range: $62,000–$68,000

Supervisory responsibilities: None currently

About the North Carolina Alliance for Health

The North Carolina Alliance for Health brings together community voices, bipartisan leaders, businesses, and partners across the state to advance practical policy solutions grounded in local experience and designed for statewide impact. Together, we improve health outcomes while reducing long-term healthcare costs, expanding access to care, strengthening the workforce, and helping communities thrive. 

About the Role

As federal funding cuts and policy shifts threaten public health and Medicaid coverage, the North Carolina Alliance for Health (NCAH) is committed to fighting for North Carolinians’ continued access to affordable care. In alignment with NCAH’s commitment to public health and ensuring health access for all, the Health Access Manager will lead and coordinate Keeping NC Medicaid Strong – a statewide coalition focused on protecting and advancing Medicaid in North Carolina.

This role requires strong skills in coalition management, stakeholder communications, and policy analysis. The ideal candidate is a strategic thinker, a skilled communicator, and committed to access to care in North Carolina.

Key Responsibilities

  • Coalition Management & Leadership

    • Manage NCAH’s health access portfolio, with a primary focus on Medicaid policy and related public health issues. 
    • Convene and grow a diverse coalition of organizations, advocates, and community partners.
    • Facilitate Keeping NC Medicaid Strong coalition meetings by setting agendas, supporting discussions, and ensuring follow-through on action items.
    • Work with the Executive Director to build and maintain relationships with key stakeholders, including advocacy groups and community leaders.
    • Manage project timelines, budgets, deliverables, and grant requirements; identify risks and recommend adjustments to keep work on track. 
    • Engage Medicaid beneficiaries, grassroots organizations, and communities most affected by health access barriers in campaign planning, messaging, and advocacy. 

 

  • Policy & Legislative Work

    • Monitor and analyze federal and state policy developments affecting Medicaid and health access; advise leadership on emerging opportunities and threats.
    • Draft policy briefs, talking points, and testimony targeted to a variety of audiences.
    • Represent the coalition with media and relevant public forums.
    • Work closely with the Executive Director to influence policy outcomes.

  • Advocacy & Campaigns

    • Implement advocacy campaigns, including grassroots mobilization and digital outreach.
    • Prepare coalition members for legislative meetings, press events, and other advocacy opportunities.
    • Track campaign progress and report on outcomes to the coalition and funders.

  • Communications & External Relations

    • Serve as a representative for NCAH’s healthcare access work in meetings with key stakeholders, funders, and the media, providing timely updates, reporting recent developments, and sharing relevant information.
    • Translate complex Medicaid and healthcare policy issues into clear, compelling messages for diverse audiences.
    • Collaborate with the communications team to draft fact sheets, advocacy toolkits, talking points, and digital content.
    • Support coalition members in amplifying unified messaging.

  • Organizational Management

    • Work with the Executive Director to support Medicaid-related grants, including budget tracking, deliverable management, and funder reporting.
    • Ensure projects are executed effectively, on time, and in alignment with NCAH’s strategic goals.
    • Contribute to funding proposals, funder cultivation, grant reports, and sustainability planning for NCAH’s health access portfolio. 
    • Develop annual goals, strategies, work plans, and performance measures for NCAH’s health access portfolio in collaboration with the full team.
    • Establish and track campaign goals, performance indicators, partner engagement, policy progress, and outcomes; use findings to improve strategy and support funder reporting.
  • Team Participation & Collaboration
  • Work closely with NCAH staff, consultants, and coalition partners to align strategies and coordinate communications.

    • Uphold NCAH's mission, vision, and values in your daily work.
    • Foster a collaborative, inclusive team culture that values diverse perspectives and lived experiences.
    • Support colleagues across projects by contributing expertise in policy, advocacy, and coalition management.

 

Qualifications

  • Minimum two to four years of health policy advocacy or NC Medicaid program experience.
  • Strong project-management skills, including the ability to manage multiple deadlines, budgets, and deliverables.
  • Familiarity with the North Carolina General Assembly, state agencies, and state policymaking processes.
  • Demonstrated ability to facilitate diverse groups, navigate differing perspectives, and build consensus.
  • Commitment to racial, geographic, disability, and economic equity.
  • Ability to work independently and adapt to rapidly changing policy conditions.
  • Willingness to travel within North Carolina and occasionally work outside regular business hours.

 

How to Apply: To apply, send your resume and cover letter to admin@ncallianceforhealth.org by September 4, 2026.

Kate Hanson, Founder and Executive Director, Meals4Families

What Is SNAP?

SNAP (Supplemental Nutrition Assistance Program) helps individuals and families with low income or no income afford groceries. It is our nation’s largest anti-hunger program, supporting tens of millions of people each month (1). In North Carolina, the SNAP program supports 1.4 million children, older adults, people with disabilities, and working North Carolinians (the equivalent of 1 in 8 people in our state), including more than 600,000 children under 18, 159,00 adults over 65, and 46,000 veterans (2).

What’s the Problem?

Recent federal legislation shifts part of the cost of SNAP food benefits from the federal government to states, a significant departure from SNAP’s long-standing federal funding structure (3). This same legislation also requires states to pay a higher share of the cost of administering the SNAP program. Starting in October 2026, states will have to pay for 75% of SNAP administrative costs, up from 50% historically. 

Paired together, the new benefit cost share requirement and the increased administrative cost share mean that continuing the SNAP program will put state budgets under enormous strain. Because states must balance their budgets, this cost shift could force some states, including North Carolina, to consider withdrawing from SNAP altogether—an outcome that would put millions of families into crisis and harm K-12 public school meal programs, local farmers, and grocery retail economies.

What This Means for North Carolina

North Carolina can’t afford the benefit cost shift and may have to exit the SNAP program entirely (2). It is estimated that NC’s SNAP benefit cost share could be over $420 million per year; coupled with the increase to a 75% administrative cost share, this means that starting in October 2027, North Carolina would need an estimated additional $436 million from the state budget each year to continue the SNAP program in our state. States can avoid this benefit cost share by bringing one specific SNAP program performance metric, called Payment Error Rate (PER), below a 6% threshold. Historically, North Carolina has consistently met this performance requirement (4). SNAP PER increased nationally during the COVID-era economic crisis, and as of 2024 the majority of states (42) had SNAP Payment Error Rates higher than 6% (2). North Carolina is on a promising path toward reducing our SNAP PER and avoiding the benefit cost share. A two-year delay in the benefit cost share implementation would give all states, including North Carolina, a fair shot at recovering from COVID-era trends and adapting to recent SNAP policy changes.

Why Everyone Should Care

North Carolina is stronger with SNAP. The SNAP program brings nearly $2.8 billion in federal dollars to our state economy each year, generating $4.2 billion in statewide economic impact (2). SNAP lifts up entire communities, not just the families and individuals who receive monthly benefits (5):

  • SNAP is one of the most effective tools for reducing hunger and poverty, particularly among children and seniors.
  • SNAP food benefits are spent at local retailers, grocery stores, and farmers’ markets, supporting County economies, retail jobs, and local farmers.
  • SNAP helps fill the gaps for workers with low and inconsistent pay, supports people who have lost jobs and are looking for work, and keeps people healthy so that they can show up to work.
  • Losing SNAP in North Carolina would increase food insecurity and force people to make difficult, and often harmful, tradeoffs between paying for food, housing, and medical care.
  • SNAP participation ensures more reliable access to food, improving physical and mental health, which also improves outcomes at school and reduces health care spending.

How You Can Take Action and Make a Difference

Protecting SNAP is urgent—and taking action is quick and easy. Here are a few simple ways you can help right now:

Send an email to Congress.
NCAH has an action alert you can use to quickly email your Members of Congress and urge them to protect SNAP and delay the SNAP benefits cost shift to Federal Fiscal Year 2030 for all states.

Join the national Day of Action on Thursday, January 15.
Participate in the #StopThatSNAPShift Day of Action by calling your Members of Congress and urging them to include a provision in their continuing resolution before January 30 that mitigates the SNAP cost shift to states.

Speak out on social media.
Get vocal online and tag your Members of Congress. You can reference this powerful coalition letter signed by multiple national organizations and use or adapt the talking points below.

Three Easy Talking Points You Can Use

  • H.R. 1 forces an unprecedented SNAP benefit cost shift onto states. North Carolina cannot afford this added cost and could even be pushed to exit the SNAP program entirely.

     

  • Congress can fix this before it wrecks state budgets, including North Carolina’s state budget.

     

  • The simplest solution: delay the SNAP benefits cost shift to the Federal Fiscal Year 2030 for all states.

     

Learn more.
Read more about this issue using one-page explainers from FRAC and the Center on Budget and Policy Priorities, which break down what’s at stake and why swift action matters.

References

    1. Center on Budget and Policy Priorities (Jan. 8, 2026) Congressional delay of SNAP cost shift urgently needed to protect food assistance for low-income families.
    2. NC DHHS (Jan. 13, 2026) Impact of H.R. 1 on SNAP in North Carolina & Implementation Update. 
    3. Share Our Strength (Oct. 7, 2025) Summary of changes to SNAP in Reconciliation (H.R. 1).
    4. The Hamilton Project (June 30, 2025) SNAP payment error rates by state, FY 2003–24.
    5. Center on Budget and Policy Priorities (Feb. 14, 2023) SNAP Is and Remains Our Most Effective Tool to Combat Hunger.

Other Posts

North Carolina Alliance for Health Applauds Health and Nutrition Investments in State Budget

Progress made on Medicaid, food security, and healthy opportunities while shifting SNAP costs to counties.The North Carolina Alliance for Health welcomes key investments included in North Carolina’s FY 2026-27 budget, recognizing the work of legislative leaders in...

North Carolina is Stronger with SNAP

For over 1.4 million North Carolinians, SNAP is more than just a program—it’s a vital lifeline. SNAP helps put nutritious food on the table for children, seniors, veterans, people with disabilities, and hard-working families across our state. When our neighbors can afford groceries, our whole community benefits.

Congress Can Act Now Before SNAP Cost Shares Wreck State Budgets 

Kate Hanson, Founder and Executive Director, Meals4Families What Is SNAP? SNAP (Supplemental Nutrition Assistance Program) helps individuals and families with low income or no income afford groceries. It is our nation’s largest anti-hunger program, supporting tens of...

Take Action-Protect Youth from Vaping and Nicotine

Youth vaping is an epidemic and North Carolina is one of the few states without a tobacco retailer permit system or an aligned age-21 sales law. Solly’s Law (HB 430/SB 318) would change that—ensuring stronger protections for our kids. This bill honors Solomon “Solly”...

NCAH Update

On January 6, 2025, Abby Carter Emanuelson will become the next executive director of the North Carolina Alliance for Health. Abby’s skills, expertise, and deep commitment to NCAH’s mission, vision, and values make her the ideal leader to guide NCAH into its next...

2024 Election Results

FEDERALPresidentNorth Carolina was one of the battleground states for control of the presidency and, once again, Republican Donald Trump won the state by a safe margin of 50.95% to 47.56%. He appears to have outperformed many of his key suburban/rural districts by at...

Resources for Communities Impacted by Hurricane Helene

We are deeply saddened by the devastation caused by Hurricane Helene across North Carolina. Many of our communities are facing devastating and significant challenges in the storm's aftermath. In this difficult time, we want to share some resources that may provide...

NCAH Statement on S527

Surprise Amendment to ABC Omnibus Bill (S527) Creates Dangerous New Exemption to North Carolina Smoke-Free Law A Statement by Morgan Wittman Gramann, Executive Director, North Carolina Alliance for Health Today, the North Carolina General Assembly passed dangerous...

Short Session Begins

Things change quickly on Jones Street. A few days ago, you may have heard us say that we expected short session to be short. Then the revenue forecast was updated. The State has $1.4 billion more than expected, and, as the saying goes, more money, more problems, and a...

New grants will help public schools provide nutritious school breakfast to more children to support their health, development and learning

Governor Cooper Directs $1.4 Million to Expand School Breakfast Programs New grants will help public schools provide nutritious school breakfast to more children to support their health, development and learning RALEIGH: Today, Governor Roy Cooper announced that he is...

Translate »