Brad Knott and the One Big Beautiful Bill Act: His Seven Decisive House Votes, a Final-Passage Yes, and the Law's Toll on North Carolina

The One Big Beautiful Bill Act pays for deficit-financed tax cuts partly with cuts to Medicaid and SNAP, and Brad Knott, North Carolina's 13th District representative, cast yes votes on its budget resolutions, its rules, House passage on May 22, 2025, which it won 215-214, and the July 3, 2025 final vote; KFF puts North Carolina's share of the Medicaid cut at $22.5 billion across ten years.

Seven of Knott's votes were decisive, among them both budget resolutions, whose instructions sought $880 billion in savings from the committee that writes Medicaid law and $230 billion from the one that writes SNAP law, and two July 2 procedural votes that cleared the way for the final version. He followed in April 2026 with a yes on a resolution lauding the law, a law KFF expects to add 300,000 North Carolinians to the uninsured by 2034.

Brad Knott's House Votes on the One Big Beautiful Bill Act, in the Order the Bill Moved

• Knott's Yes Decided the February 2025 House Budget Plan Ordering $880 Billion in Savings From Medicaid's Committee and $230 Billion From the Agriculture Committee. Knott voted yes three times on the House budget on Feb. 25, 2025: ordering the previous question on H.Res. 161 (216-210), adopting that rule (217-211), and adopting H.Con.Res. 14 itself (217-215). One flipped vote from him would have left the resolution deadlocked, and a deadlocked House question fails. Its reconciliation instructions asked Energy and Commerce, Medicaid's committee, to "reduce the deficit by not less than $880,000,000,000" over ten years, asked Agriculture, SNAP's committee, for at least $230 billion, and gave Ways and Means room for as much as $4.5 trillion in new deficits.
• Knott Cast the Deciding Votes on the April 2025 Rule and the Budget Resolution Behind the Law's Medicaid Cuts. Knott's April 9, 2025 votes ordered the previous question on H.Res. 313 (217-212) and adopted the rule (216-215), which set up a vote on the Senate-amended budget resolution; on April 10 his yes helped the House accept that version, 216-214. A Knott no on April 9 would have sunk the rule outright, and on April 10 it would have left the resolution in a losing tie. Because the House committees' instructions survived unchanged, Energy and Commerce kept its $880 billion target; the Medicaid cuts in the version Knott voted for on July 3 came to $911 billion across ten years by CBO's estimate, per KFF.
• Knott Was One of 215 Yeas as the House Bill Cleared by a Single Vote in May 2025. Six times on May 22, 2025, Knott voted to move H.R. 1 along or keep it intact: twice to consider its rule, H.Res. 436 (217-211, 216-211), once to order the previous question (213-211), once to adopt the rule (217-212), and once against the motion to recommit, which lost 212-216; then on passage he joined the 215 yeas that beat 214 nays, with one member voting present. The previous question and passage each hinged on his vote. Once the Senate rewrote it, the measure became a law whose Medicaid provisions by themselves add 7.5 million uninsured people by 2034, a CBO figure reported by KFF, and that cut Planned Parenthood out of Medicaid payments for a "1-year period".
• Knott's Votes Decided Two July 2025 Procedural Tests Before He Voted for Final Passage. To bring the Senate version to the floor on July 2, 2025, the House first had to agree to consider H.Res. 566, which it did 212-211, and then order the previous question, 214-212; Knott voted yes both times, and a no from him would have sunk the first outright and left the second tied, and a tie fails. After that he voted yes on the Foxx amendment to the rule (220-212), the amended rule on July 3 (219-213), and, for final passage, the motion to concur in the Senate's changes (218-214). It was enacted as Public Law 119-21 on July 4, 2025. By KFF's reporting of CBO's numbers, 10 million more people will lack insurance in 2034 under the law, and CBPP concluded that "The megabill cuts SNAP by $187 billion or about 20 percent by 2034."
• Knott Voted for an April 2026 Resolution Hailing the Law's Tax Provisions as Help for Working Families. Knott's April 16, 2026 yes helped adopt H.Res. 1156, 219-207; the resolution brands the law the "Working Families Tax Cuts" and says it "will result in a 15 percent tax cut for Americans whose income is in the bottom 40 percent." ITEP's 2026 analysis says otherwise for those at the bottom, "For the poorest fifth of Americans, the average tax change from OBBBA is a small tax increase," while the top 1 percent average a cut above $70,000.

What the One Big Beautiful Bill Act Brad Knott Voted For Does to North Carolina, Topic by Topic

• 216,400 Medicaid enrollees in North Carolina's 13th District depend on a program losing $22.5 billion in the state. KFF counts 216,400 Medicaid enrollees in North Carolina's 13th District, 26% of residents, and puts the state's ten-year federal Medicaid loss at $22.5 billion; the votes and the hospital-tax caps are on Brad Knott's health care page.
• The law's provider-tax cap threatens the hospital money that pays for North Carolina's Medicaid expansion. The North Carolina Medical Journal reported that the lower cap costs the state and its hospitals the HASP payment program, roughly $32 billion in federal money over a decade, and state law ends expansion coverage if hospital assessments cannot cover the state's share. More is on Knott's health care page.
• The law alone leaves 300,000 more North Carolinians uninsured by 2034. KFF's projection for 2034 has the law by itself raising North Carolina's uninsured count by 300,000, and WRAL reported that up to a quarter-million people in the state could be pushed off Medicaid starting in 2027. The effect on low-income families is on Knott's homelessness and poverty page.
• $6.37 billion in federal Medicaid money drains from rural North Carolina over a decade. KFF estimates a $6.37 billion ten-year cut to federal Medicaid spending in rural North Carolina, money that pays rural hospitals and clinics for their patients' care. Rural hospital effects are on Brad Knott's health care page.
• The hospital fund serving 2.2 million North Carolina Medicare enrollees now runs dry a quarter sooner. With 2,228,458 people on Medicare in 2024, North Carolina has a large stake in the hospital trust fund, whose projected depletion the law's tax changes moved one quarter earlier, to the second quarter of 2033; and under the same law some lawfully present immigrants lose Medicare altogether. See Knott's Medicare page.
• Medicaid is the main payer for 60% of North Carolina's nursing-home residents as the staffing standard is shelved. Six in ten of the 35,329 people in North Carolina's certified nursing facilities rely mainly on Medicaid, and the law blocks the federal staffing floor until 2034; Knott's elder care page explains both.
• 24,000 people with disabilities in North Carolina's 13th District rely on Medicaid. Among Medicaid enrollees in North Carolina's 13th District, KFF counts 24,000 with disabilities, and 22,300 North Carolinians were on home care waiting lists in 2026; Brad Knott's disability rights page explains the work-rule exemptions.
• 16,568 North Carolina Medicaid adults were on opioid treatment medication that coverage losses can interrupt. In 2021, KFF data show, 16,568 North Carolina Medicaid adults diagnosed with opioid use disorder, out of 31,882, were getting medication for it; how the work rule handles people in treatment is on Knott's mental health and addiction page.
• CBPP's estimate of the same SNAP expansions found 90,000 North Carolinians at risk, and counties absorb $52 million in new costs. CBPP estimated in June 2025, for a Senate Agriculture Committee proposal with the same expansions, that 47,000 North Carolinians between 55 and 64 and 43,000 parents whose youngest child is at least 14 were at risk of losing SNAP, and the state's counties face about $52 million in new administrative costs in the first year. Brad Knott's food assistance page has more.
• SNAP's new benefit cost share could cost North Carolina about $140 million in fiscal 2028. The Center on Budget and Policy Priorities estimates the law's benefit cost-share will cost North Carolina about $140 million in fiscal 2028, based on its fiscal 2025 error rate of 7.36 percent, one of the costs the law moves from Washington to the state. Knott's taxes and deficit page covers who gains and who pays.
• Too little income for the full child tax credit: 49,000 children in North Carolina's 13th District. That count, 28% of the district's children, comes from Columbia University's poverty center, which estimated how many families earn too little for the whole credit under the law; the related votes are listed on Brad Knott's child care and families page.
• In North Carolina's 13th District, 142,357 people draw Social Security from a fund the law weakens. In December 2024, 142,357 people in North Carolina's 13th District received Social Security, and the law raises Social Security's net program cost by $168.6 billion through 2034, pulling the retirement fund's shortfall forward. Knott's Social Security page has the votes.
• Moving from SAVE to the new repayment plan costs North Carolina borrowers $1,767 a year. By the Center for American Progress's estimate, a North Carolina borrower who switches from SAVE to the Repayment Assistance Plan pays an average of $1,767 more per year; Brad Knott's student debt page explains the changes.
• The veterans' SNAP exemption ended for households that include 47,000 North Carolina veterans. SNAP reached the households of an average of 47,000 North Carolina veterans in 2021-2023, and the law removed the exemption that had kept veterans out of the program's three-month time limit; more is on Knott's veterans page.
• Energy costs for a typical North Carolina household could climb by about $490 a year by 2035. Energy Innovation's projection, reported by CNBC, is that the law's energy provisions could push a typical North Carolina household's annual energy bill up by about $490 by 2035.
• The Medicaid cuts could cost North Carolina as many as 30,000 jobs. In a worst case, the law's Medicaid cuts could mean up to 30,000 layoffs in North Carolina, according to a Commonwealth Fund analysis that WRAL reported in May 2026.

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Last updated: 2026-10-27

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