Annie Murrow, a Human Services Department staff member, told the Consolidated Human Health Services Board that provisions in the federal reconciliation bill will alter Medicaid expansion and SNAP program rules and could raise state and local costs.

Murrow said the bill adds a Medicaid expansion work requirement for people ages 19 to 64, requiring work or approved activities such as job training or community service for more than 80 hours per month, and institutes a six-month eligibility determination for all Medicaid expansion cases for renewals occurring on or after Dec. 31, 2026. The change will increase casework for county staff, Murrow said.

The changes to the Supplemental Nutrition Assistance Program, or SNAP, begin in October 2027, Murrow said. Currently the federal government pays 100% of benefit costs for SNAP; under the new rules states must pay a share based on the SNAP payment error rate. Because North Carolina’s error rate is slightly above 10% (Murrow said about 10.3%), the state’s cost share would be 15%, which she said could amount to approximately $420,000,000 per year statewide. Murrow also said administrative-cost sharing will change in October 2026 so the federal government pays 25% and the state and counties pay the remaining 75%.

Why this matters: Murrow told the board these shifts could increase workload for county human services staff and expose counties to a larger share of SNAP administrative costs. Commissioner Branch asked Murrow to repeat the percentages and the $420 million estimate; Murrow clarified that the $420 million estimate refers to a potential statewide cost tied to the error-rate formula and that the 25/75 split applies to administrative costs.

Discussion versus decision: The board received the update as information; no formal action was taken, and Murrow did not present a recommendation for a board vote. The presentation combined policy details (timelines and eligibility changes), cost estimates and operational impacts (staff workload and administrative-cost shares). Murrow described some figures as estimates and did not provide county-specific dollar figures.

Additional clarifying details recorded in the meeting: Murrow said the Medicaid work requirement applies to ages 19–64 and requires roughly 80-plus hours of approved activities per month; the six-month eligibility determination applies to expansion case renewals on or after Dec. 31, 2026; SNAP program changes tied to an error-rate calculation would take effect Oct. 2027 and administrative-cost-sharing changes take effect Oct. 2026. Murrow said North Carolina’s current SNAP error rate is slightly above 10% and that the $420,000,000 figure is an estimated statewide cost. Murrow also said SNAP ages for certain work requirements were increased to ages 18–64.

No vote or directive was recorded. The board did not set follow-up tasks or ask staff to prepare a budget estimate specific to this county during the public presentation.