With a final vote in the U.S. House of Representatives on Thursday, a sweeping tax bill that will touch almost every sector of the economy and overhaul industries like energy and health is headed to President Donald Trump's desk for a signature.
In North Carolina, Gov. Josh Stein, a Democrat, has spent much of the week rallying against what Republicans have dubbed the "One Big Beautiful Bill."
Stein warned that it could threaten the healthcare of as many as 1.2 million North Carolinians; cause 1.4 million people in the state to lose food assistance unless the state can find $420 million to support the program; and cost 45,000 jobs by stymying the state's burgeoning clean tech manufacturing sector.
"The bill is a disgrace, and I am disappointed in those who did not stand up for the people they serve, choosing instead to ignore warnings from local leaders and groups across the state who have sounded the alarm about the dangers in this bill. We cannot simply accept these harmful impacts," Stein wrote in a statement after its passage.
Stein also called upon the Republican-controlled N.C. General Assembly to protect the state's Medicaid expansion, which ensures about 670,000 people. The program's future is imperiled by a state provision that effectively removes North Carolina it if the federal government stops covering a large portion of the cost.
Additionally, Stein wants the General Assembly to provide about $420 million in funding that he says would now be necessary to keep North Carolina enrolled in the federal Supplement Nutrition Assistance Program.
"This will require taking a hard look at our laws, our state budget, and our long-term revenue requirements," Stein wrote.
Sen. Thom Tillis, R-N.C., pointed to the Medicaid provision as a key reason for his opposition to the bill shortly before voting against it and announcing his retirement. Sen. Ted Budd, R-N.C., voted for the bill.
In a letter to the state's Congressional Delegation this week, Stein wrote that in addition to the Medicaid expansion population, another 520,000 North Carolinians could lose health insurance. Those people's coverage is threatened by changes to Medicaid, Marketplace health plans and subsidies, Stein wrote.
N.C. Department of Health and Human Services officials said Thursday they are reviewing the bill's final language to determine its full impact, but warned the changes to Medicaid and food assistance will likely cost the state billions of dollars.
"These cuts not only impact the people that rely on them directly but also strain the systems and communities that hold us all together," DHHS Secretary Dev Sangvai said in a statement.
Congressional response
All 10 Republican members of the state's delegation in the U.S. House of Representatives voted for the bill, while all four Democrats voted against it.
U.S. Rep. Don Davis, N.C.-1, whose Eastern North Carolina district is seen as the only competitive Congressional race in the state, expressed disappointment in the bill's passage Thursday afternoon.
"While I wholeheartedly support safeguarding the American people by strengthening our national defense and securing our border, it is also deeply concerning that the average hardworking family in eastern North Carolina will bear the brunt of H.R. 1’s out-of-touch spending, as the wealthiest individuals and Washington, D.C. insiders stand to benefit the most," Davis wrote in a statement.
Republicans touted passage of the bill, including U.S. Rep. Greg Murphy, N.C.-3, a practicing physician who was known to be concerned about the Medicaid provisions in the package and how they would impact rural healthcare.
In a statement, Murphy touted tax cuts and additional spending on border security. He also referenced "innumerable dynamic and spirited conversations" with Trump Administration officials about rural health.
"This bill protects Medicaid benefits for those who are most vulnerable in our society, not able-bodied individuals capable of participating in the workforce, illegal immigrants, and those ineligible for benefits. The $50 billion Rural Health Transformation Program, included in the package, ensures the sustainability of rural health providers with an immediate impact beginning next year," Murphy wrote in a statement.
U.S. Rep. Mark Harris represents the 8th Congressional District that stretches from eastern Mecklenburg County to Robeson County. In a statement, Harris wrote that he is proud to uphold President Donald Trump's agenda, including completing the border wall and taking federal funding away from Planned Parenthood.
Harris also expressed concern, though, about the amount of new spending in the bill, which the nonpartisan Congressional Budget Office projects will add more than $4 trillion to the United States' deficit.
"I recognize to undo the damage done to our country by radical progressive Democrats, Congress must authorize the funds to accomplish that goal. However, I fear that if Washington’s overspending addiction continues, the opportunity to put our country back on a path to a sound financial future is in jeopardy. In the coming months, Republicans must use every tool at our disposal to rein in government spending," Harris wrote.
