The One Big Beautiful Bill Act's work requirement makes Medicaid expansion adults report 80 hours of activity a month unless an exemption applies, such as being blind or disabled, having a disabling mental disorder or having a serious or complex medical condition, and Brad Knott, who represents North Carolina's 13th District, voted for it on July 3, 2025 after casting a deciding vote for the House version; the Centers for Medicare and Medicaid Services projects the rule will reduce enrollment by 2.3 million people in fiscal 2027.
Knott's votes in February and April 2025 each decided the budget resolution, whose instruction to the Medicaid committee called for no less than $880 billion in savings, and when Medicaid is cut, optional services are the most exposed, including the home care that lets people with disabilities live outside institutions. KFF counts 24,000 people with disabilities among Medicaid enrollees in his district.
Brad Knott's Votes on Medicaid Work Rules and Disability Coverage
- Knott Voted for a Medicaid Work Requirement That Can Drop Disabled Expansion Adults the State's Records Miss, Cutting 2.3 Million From Enrollment. Knott's July 3, 2025 yes helped enact the One Big Beautiful Bill Act, 218-214, six weeks after his vote helped the House version squeak through 215-214. Under the law, expansion adults owe 80 hours a month of work or another approved activity unless an exemption covers them. The exemptions include a person who is "blind or disabled (as defined in section 1614)," one "with a disabling mental disorder," and one "with a physical, intellectual or developmental disability that significantly impairs their ability to perform 1 or more activities of daily living," and states check them using "reliable information available to the State." The Centers for Medicare and Medicaid Services estimates that under the requirement "enrollment would be reduced by 2.3 million individuals in FY 2027."
- Knott's Deciding Budget Votes Set the $880 Billion Savings Target for Medicaid's Committee That Threatens Optional Home and Community-Based Care. The House adopted H.Con.Res. 14 by 217-215 on February 25, 2025 and its final version by 216-214 on April 10, 2025, with Knott voting yes both times; in each case his switch alone would have produced a tie, and a tie fails. The resolution told the committee with authority over Medicaid to "reduce the deficit by not less than $880,000,000,000" over ten years. Home and community-based services, which pay for the aides and supports that let people with disabilities live at home rather than in institutions, are "largely an optional Medicaid benefit," and the Bipartisan Policy Center reports experts' view that the law will "slow or reverse recent HCBS expansion efforts" in the states.
What the Medicaid Changes Brad Knott Voted For Mean for North Carolinians With Disabilities
- 24,000 people with disabilities in North Carolina's 13th District rely on Medicaid as the law cuts it. Medicaid covered 24,000 people with disabilities in North Carolina's 13th District in 2025, KFF counts, along with 42,600 adults in the expansion group to which the work requirement applies. States check exemptions against data they already hold, so an expansion adult whose disability is missing from those records can still lose the coverage that pays for wheelchairs, therapy and prescriptions.
- Up to a quarter-million North Carolinians could lose Medicaid starting in 2027. WRAL reported in May 2026 that the law's changes could remove up to a quarter-million North Carolinians from Medicaid starting in 2027. North Carolina's expansion, which the work requirement targets, has covered more than 685,000 additional people, according to the North Carolina Medical Journal.
- 22,300 North Carolinians are waiting for Medicaid home care that the law makes harder to fund. North Carolina had 22,300 people on Medicaid home and community-based services waiting lists in 2026, KFF reports. With $22.5 billion less in federal Medicaid money over ten years, optional services like these are where the state can trim, which leaves people with disabilities waiting longer for the help that keeps them in their own homes.
Frequently Asked Questions About Brad Knott on Disability rights
What is Brad Knott's record on disability rights under Trump?
Brad Knott voted in 2025 for a law, the One Big Beautiful Bill Act, under which a disabled adult in Medicaid's expansion group can lose coverage over its work requirement if the state's data miss the condition that exempts them, which federal officials expect to cut enrollment by 2.3 million in fiscal 2027. His votes decided the House version and both votes on the budget resolution that gave the committee over Medicaid an $880 billion savings target. In North Carolina's 13th District, 24,000 people with disabilities are enrolled in Medicaid.
How does a North Carolinian with a disability keep Medicaid under the work requirement Brad Knott voted for?
The law Brad Knott voted for exempts an expansion adult in North Carolina from reporting hours if they are "medically frail or otherwise has special medical needs," a category that reaches people who are blind or disabled, those with a disabling mental disorder and those with a serious or complex medical condition. Anyone who qualifies for Medicaid through a disability is not in the expansion group, so the requirement does not apply to them. The state checks exemptions against data it already has, so an expansion enrollee whose condition is missing from those records can still be dropped. The rule must start "no later than January 1, 2027."
What does the law Brad Knott voted for change about paying old medical bills for disabled patients in North Carolina?
The law Brad Knott voted for shortens Medicaid's look-back for bills run up before a person applies: from January 1, 2027, coverage reaches back one month for expansion adults and two months for other enrollees, where states had been required to cover up to 90 days, KFF reports. A North Carolinian who becomes disabled after an accident and applies weeks later can be left owing hospital bills that Medicaid once would have paid.
Last updated: 2026-10-27