How does H.R. 1 (One Big Beautiful Bill Act) affect my Medicaid benefits with Insight Carolinas?
Aug. 22, 2025
With the passage of H.R. 1 (more commonly known as the “One Big Beautiful Bill Act” or OBBBA), Medicaid is slated to have an estimated $860 billion cut nationally over the next few years. States are entrusted to administer the federal program, and have a responsibility to contribute to the benefits as well, which is how the NC Medicaid Expansion was funded in 2023.
North Carolina Governor Josh Stein has signed SL 2025-89 (formerly known as H124), which cuts about 1/3 out of the budget that preceded OBBBA. The NC DHHS Secretary Dr. Devdutta Sangvai made a press release earlier this month regarding the shortfall, indicating the need to balance cuts, sustain access to care, and to comply with the administrative demand for federal requirements related to work verification. The current plan by North Carolina is to make cuts to provider rates, close particular program such as Healthy Opportunities, and discontinue coverage of certain medications such as GLP-1 obesity management medication. Local Managed Entity/Managed Care Organizations (LME/MCOs) are beginning to notify Insight Carolinas and other Medicaid mental health providers of rate cuts, which based on available data will be about an 8% cut for outpatient mental health care. Given that the profit margin for most mental health practices is 5% or less, DHHS anticipates that some providers will leave Medicaid due to even tighter margins, resulting in potentially longer wait times for care.
At this time, Insight Carolinas has decided to continue seeing clients for therapy and psychological assessment for Medicaid beneficiaries. We are in contact with LME/MCOs regarding changes, as well as exploring other cost savings measures in our operations, so that we can continue to serve those in need of mental health services in North Carolina.
We know that there are mental health care gaps in North Carolina, and we remain committed to doing what we can to meet this need. The leadership team is prayerfully and considerately navigating this changing landscape, while keeping Insight Carolinas a great place to work.
For questions related to NC HR1 Medicaid changes or to review your NC Medicaid plan options, please visit https://ncmedicaidplans.gov/.