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County staff outline federal Medicaid and SNAP changes, estimate $420 million state cost
Summary
A county human services official summarized changes in a federal reconciliation bill that would add Medicaid expansion work requirements and require states to share SNAP benefit costs, estimating a $420 million annual impact for North Carolina and increased local administrative expenses.
Annie Murrow, a department representative for the consolidated human services board, told the board that a recent federal reconciliation bill would add work requirements to Medicaid expansion and change how the Supplemental Nutrition Assistance Program is funded. "This policy starts for renewals happening on or after 12/31/2026," Murrow said of the Medicaid expansion renewal policy, and she told commissioners the SNAP change could cost the state about $420,000,000 per year.
Why it matters: The changes would shift program administration and costs across federal, state and county levels, potentially increasing workload for county staff and local budgetary pressure.
Murrow summarized several provisions she said are in the reconciliation bill. For Medicaid expansion, she said a work requirement would apply to people ages 19 to 64 and require 80 or more hours a month of work or approved activities such as job training or community service. "This policy starts for renewals happening on or after 12/31/2026," she said. Murrow said the new policy will require a six-month eligibility determination for all Medicaid expansion cases.
On SNAP, Murrow said the federal government currently pays 100% of benefit costs but that from October 2027 states will be required to pay a portion of benefits based on each state's SNAP payment error rate. She said North Carolina's error rate is just above 10 percent and that would translate to a 15 percent state cost share under the new formula, which she estimated at about $420,000,000 per year.
Murrow also said the reconciliation bill would change administrative funding for SNAP beginning October 2026: federal funding would cover 25 percent of administrative costs while the remaining 75 percent would be split between state and counties. "There will be changes in the administrative costs," Murrow said.
Discussion and clarification: Commissioner Branch asked Murrow to repeat the percentage figures and confirm whether counties would share the financial burden. Murrow clarified that the 15 percent figure referred to the benefit cost share tied to the error rate and that the 75 percent state-and-county share applied to administrative costs.
Outcome and next steps: The item was informational; the board took no formal action on the policy summaries during the meeting. Murrow concluded by saying the changes "will lead to more work for our staff," and no motion or directive to staff was recorded during the discussion.
