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32 <br /> TO: Senator Thom Tillis <br /> Senator Ted Budd <br /> Representative Valerie Foushee <br /> FROM: Orange County NC Board of Commissioners <br /> DATE: March XX, 2025 <br /> RE: NC Association of County Commissioners — Common Concerns <br /> Executive Summary <br /> On March 1 —4, 2025, the National Association of Counties (NACo) Legislative Conference was <br /> held in Washington, DC. At this conference, NACo, as well as the NC Association of County <br /> Commissioners (NCACC), identified areas where current White House and Congressional <br /> budget reconciliation discussions may have major impact on county government services to our <br /> communities. <br /> These areas included: <br /> 1. Medicaid cuts <br /> 2. Cuts to Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for <br /> Needy Families (TANF) and Child Protective Services <br /> 3. Elimination / Reform of FEMA <br /> 4. Removal of Federal tax exemption on interest received on municipal bond holdings <br /> There was strong bipartisan concern expressed about cuts in these areas and their impact. We <br /> share this concern. <br /> Below, we share specifics with how these programs support our county's residents, and we are <br /> writing to urge you to avoid these impacts to our counties across North Carolina. <br /> Potential Impacts <br /> 1. Medicaid cuts: <br /> As of December 1, 2023, Medicaid was expanded in North Carolina and now also covers <br /> people aged 19 to 64 with incomes up to 138% of the Federal poverty level (about <br /> $20,000/yr for an individual and $34,000/yr for a family of three). <br /> North Carolina statute requires that any cuts that would reduce the Federal Match below <br /> 90% will result in termination of expanded Medicaid benefits. <br /> In our county, <br /> o More than 4,600 residents have been enrolled in the expanded Medicaid <br /> program since 12/01/2023. (2) <br /> o Over 21,000 residents were enrolled in "Traditional" Medicaid coverage in 2024. <br /> (2) <br /> o Approximately 3,900 individuals currently receiving Medicaid (19%) are older <br /> adults or adults with disabilities. <br />