North Carolina is facing a wave of federal funding losses and service disruptions after President Trump signed his flagship domestic legislation—the “One Big Beautiful Bill”—into law. The measure, passed narrowly through Congress despite bipartisan objections, enacts deep cuts to Medicaid, the Supplemental Nutrition Assistance Program (SNAP), and clean energy tax incentives. State officials warn that the consequences will be especially severe for rural communities, working families, and the clean energy workforce.

At the core of the legislation is a rollback of federal support for Medicaid expansion. North Carolina only recently adopted expansion in December 2023, extending coverage to more than 670,000 residents. With the new law in effect, nearly 700,000 North Carolinians could lose health coverage, according to estimates from the state’s Department of Health and Human Services (DHHS). Over the next decade, North Carolina could lose $40 billion in federal Medicaid funding, including $6.4 billion specifically earmarked for rural healthcare. The Sheps Center at UNC-Chapel Hill estimates more than 300 hospitals nationwide, including several in North Carolina, now face a heightened risk of closure.

The law also implements sweeping cuts to SNAP, which provides food assistance to low-income individuals and families. In North Carolina, more than 1.4 million residents rely on the program. Under the new funding formula, the state may be forced to cover $700 million in SNAP costs—an expense Governor Josh Stein has called “untenable and unjust.”

Nationally, the Congressional Budget Office projects that 2 million Americans could lose SNAP benefits entirely. State officials argue the burden will fall disproportionately on rural and economically distressed counties.

Governor Stein joined Tillis in condemning the bill, warning it would “pull the rug out from under families who rely on SNAP to put food on the table.” North Carolina’s Department of Health and Human Services echoed the concern, forecasting widespread disruption to basic services.

Beyond health and nutrition, the bill ends the 30% federal tax credit for residential solar installations by year’s end and phases out utility-scale renewable energy incentives. North Carolina’s clean energy sector — which has attracted more than $20 billion in private investment — is now bracing for widespread job losses.

Southern Energy Management CEO Will Etheridge warned his 190 employees in Raleigh that up to 55 jobs could be eliminated. “This legislation shifts incentives from middle-class homeowners to large corporations, and it may decimate one of the fastest-growing industries in the state,” he said.

Consequently, The bill passed the Senate in a 50–50 tie broken by Vice President J.D. Vance and cleared the House in a narrow 218–214 vote. All North Carolina House Republicans supported the bill; all Democrats opposed it. However, Republican Senator Thom Tillis broke with his party, voting no and citing deep concerns about the bill’s impact on his state’s hospitals and working families. He pointed to the closure of Martin General Hospital in Williamston as a sign of what’s to come if funding is slashed.

In a surprise announcement following the vote, Tillis confirmed he will not seek re-election in 2026. He attributed the decision to a collapse of bipartisan leadership in Washington and said the bill represented “a betrayal” of rural North Carolina.

Tillis’s departure opens a competitive Senate seat in a battleground state. Former Governor Roy Cooper is reportedly considering a run. A recent Catawba-YouGov poll shows Cooper with a 53% approval rating, far outpacing both Trump (46%) and Tillis (33%). Political analysts suggest Cooper’s statewide appeal and fundraising strength could make him a top-tier candidate.

The same poll shows a growing disconnect between federal policy and public sentiment. Fifty-seven percent of North Carolinians opposed federal cuts to hurricane recovery aid, while majorities also expressed concern about Medicaid and SNAP reductions. Support for Trump’s policies has declined since March, with approval ratings slipping below 50%.