Greg Murphy on Disability Rights: Medicaid Work Rules That Reach Disabled Adults in the Expansion Group, Budget Votes That Put Home Care at Risk, and 34,400 Enrollees in North Carolina's 3rd District

Federal regulators project 2.3 million fewer Medicaid enrollees in fiscal 2027 from the work rules Greg Murphy voted for. His vote came on July 3, 2025. The law exempts adults it calls medically frail, disabled people among them, yet under the federal rule that exemption is among the hardest to verify. Starting by January 1, 2027, adults in the group with no exemption must report 80 hours a month.

Murphy also cast deciding votes in February and April 2025 for the budget resolution. It set an $880 billion savings target for Medicaid's committee. Home care for disabled people is an optional Medicaid benefit, which makes it an easy target for cuts. The district he represents, North Carolina's 3rd, had 34,400 Medicaid enrollees with disabilities in 2025.

Greg Murphy's Votes on Medicaid for People With Disabilities

Murphy Voted for Work Rules That Reach Disabled Adults in Medicaid's Expansion Group. Greg Murphy's yes on July 3, 2025 helped the final One Big Beautiful Bill Act pass, 218 to 214. In May he had been one of the 215 votes that passed the House version over 214. The law makes covered Medicaid adults report 80 hours a month of work or similar activity. Its exemptions include anyone "who is blind or disabled (as defined in section 1614)" and anyone "with a physical, intellectual or developmental disability that significantly impairs their ability to perform 1 or more activities of daily living." Federal Medicaid officials at CMS forecast that "enrollment would be reduced by 2.3 million individuals in FY 2027."
Murphy's Deciding Budget Votes Left Home Care for Disabled People Exposed. H.Con.Res. 14 passed 217 to 215 on February 25, 2025, and its final version passed 216 to 214 on April 10, 2025. Murphy voted yes both times; either switch would have produced a tie that sinks a resolution. Its instruction to Medicaid's committee: "reduce the deficit by not less than $880,000,000,000" over ten years. Home and community-based services let disabled people live at home rather than in an institution. They are "largely an optional Medicaid benefit," the Bipartisan Policy Center notes, and so "more vulnerable to reductions during periods of state or federal budget constraints." Experts expect the law to "slow or reverse recent HCBS expansion efforts" in the states.

34,400 disabled residents of North Carolina's 3rd District count on Medicaid. Of 266,600 Medicaid enrollees in North Carolina's 3rd District in 2025, 34,400 had disabilities, KFF's district data show. Their coverage runs on federal Medicaid dollars that shrink under the law Murphy voted for.
22,300 North Carolinians are stuck on home care waiting lists before the cuts arrive. North Carolina had 22,300 people on Medicaid home care waiver waiting lists in 2026, KFF reports. A state facing smaller federal payments has less room to shorten those lines.
Disabled adults among North Carolina's 685,000 expansion enrollees face exemption paperwork. Expansion brought more than 685,000 North Carolinians into Medicaid, the North Carolina Medical Journal reports. Those adults fall under the work rule. Under the federal rule, the medical frailty exemption "will be more difficult to verify than others," Georgetown's Center for Children and Families warns.
North Carolina home care paid by hospital assessments could be cut. Hospital assessments help fund North Carolina's home and community-based services. With the law's lower provider-tax cap, the North Carolina Medical Journal says that funding could face cuts or end over time.

What is Greg Murphy's record on disability rights under Trump?

Greg Murphy voted in July 2025 for Medicaid work rules that make disabled adults in the expansion group report their hours unless they qualify for an exemption. Federal regulators project 2.3 million fewer enrollees in fiscal 2027. In February and April 2025, his deciding budget votes gave Medicaid's committee an $880 billion savings goal, which put optional home care at risk. North Carolina already has 22,300 people waiting for that care.

Does the Medicaid work rule Greg Murphy voted for apply to people with disabilities?

Greg Murphy's July 2025 vote went to a rule that exempts disabled adults the law calls medically frail. They include people who are blind or disabled as section 1614 of the Social Security Act defines it, and people whose condition significantly limits daily activities. Under the federal rule, the state checks its own data first and asks for documents when that data falls short, Georgetown's Center for Children and Families explains. Adults who cannot establish an exemption must report work hours or lose coverage.

Did Greg Murphy vote for cuts that threaten home care for disabled North Carolinians?

Greg Murphy did, with deciding budget votes in 2025 and a vote for the final law. Home care is an optional Medicaid service, which the Bipartisan Policy Center says leaves it more exposed when budgets tighten. In North Carolina, the provider taxes that help pay for it "may be in jeopardy of facing reductions or being eliminated entirely over time," the North Carolina Medical Journal reported.

Last updated: 2026-10-27