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 advancing policies that support healthier communities across the state. 

Governor Josh Stein signed the $34 billion spending plan on Tuesday, officially concluding a budget cycle that spanned more than a year due to policy disagreements between House and Senate Republicans.

The budget includes critical investments that help connect more children, families and adults with health care, nutritious food and other essential supports. Together, these investments improve health outcomes, reduce barriers to care and address the root causes of poor health.

Key investments include:

• Fully funds the Medicaid rebase.
• Restarts the Healthy Opportunities Pilot, an innovative Medicaid initiative that addresses food insecurity, housing, transportation and other non-medical factors that influence health.
• Continues support for children's health coverage administration (CHIPRA).
• Funds SUN Bucks, providing a one-time summer payment of $120 to purchase food.
• Invests $2.5 million in Farm to School for elementary schools to purchase local produce and products. 
• Provides greater flexibility in administering the state's Meal Incentive Program, making it easier for eligible schools to participate in the Community Eligibility Provision (CEP) and expanding access to healthy school meals at no cost. 
• Funds the state's share of SNAP administration, helping maintain North Carolina's SNAP program, while shifting new administrative costs to counties. 

These investments recognize that access to health care and healthy food are fundamental to the well-being and productivity of North Carolina families. We appreciate the work of legislative leaders to advance these priorities and strengthen programs that help children, families and communities thrive.

North Carolina's nutrition programs are designed to complement one another. SNAP participation helps more schools qualify for the Community Eligibility Provision, while the Meal Incentive Program helps schools that are financially on the cusp of CEP participation bridge the remaining funding gap and offer healthy school meals to every student at no cost. Combined with SUN Bucks and Farm to School, these investments create a stronger, year-round network of nutrition supports for children and families.

Lower SNAP administrative costs reflect a nationwide decline in SNAP participation following changes enacted through federal restrictions. This does not necessarily mean fewer North Carolinians are going hungry as many families continue to struggle to afford healthy food, underscoring the importance of maintaining strong nutrition programs. 

While encouraged by the progress reflected in the budget, additional work remains. The budget does not address the increased Medicaid copays enacted earlier this session, which will increase out-of-pocket costs for many beneficiaries. We will continue to advocate for reducing the Medicaid work requirement lookback period from three months to one month to support continuity of coverage. 

We appreciate the thoughtful work that shaped this budget and the meaningful progress it represents. There is still more to do. Every North Carolinian deserves reliable access to food and health care, and we look forward to working with lawmakers and partners across the state to build on this momentum.

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