Greg Murphy voted for a law that strips $22.5 billion of federal Medicaid support from North Carolina within a decade. His first vote came on May 22, 2025. The House bill passed 215 to 214 and needed his yes. His second came on July 3, 2025, when the final law passed.
Twice in early 2025, in February and April, Murphy's vote decided the budget plan behind the bill. Under that plan, the committee that writes Medicaid law had to find no less than $880 billion in deficit savings. In North Carolina's 3rd District, 266,600 people were on Medicaid in 2025, about a third of all residents.
Greg Murphy's Votes to Cut Medicaid
- Murphy Voted for a Law That Cuts North Carolina's Medicaid Funding by $22.5 Billion. Greg Murphy voted yes on H.R. 1 on May 22, 2025. It passed 215 to 214, with one member voting present. Without his vote it would have failed. He voted yes on final passage on July 3, 2025. The tally was 218 to 214. As enacted, the law has the Congressional Budget Office seeing Medicaid spending drop $911 billion in a decade. Its projection adds 10 million uninsured people in 2034. KFF's split of the cut assigns North Carolina $22.5 billion. That equals 11% of the state's expected federal Medicaid funds.
- Murphy Cast Deciding Votes for a Budget That Set an $880 Billion Savings Target for Medicaid's Committee. Murphy's yes on February 25, 2025 helped adopt H.Con.Res. 14, 217 to 215. His yes on April 10, 2025 helped adopt its final version, 216 to 214. Had he switched either time, the vote would have tied, and a tie fails. The resolution told the Energy and Commerce Committee to "reduce the deficit by not less than $880,000,000,000". That committee writes Medicaid law. Murphy also voted for the May 22, 2025 rule for debating H.R. 1. The cuts to Medicaid itself came later, in the final law, which carried Murphy's July 3, 2025 vote. One caps the provider taxes states use to pay their share. The Congressional Budget Office scores that cap alone at $191 billion over ten years. Another limits the extra payments states direct to hospitals. Under it, KFF found, "payment rates for hospital services will decrease in at least 37 states" beginning in 2028.
What Greg Murphy's Medicaid Votes Cost North Carolina and Its 3rd District
- 266,600 people in North Carolina's 3rd District depend on Medicaid. Medicaid enrolled 266,600 residents of North Carolina's 3rd District in 2025, KFF data show. That is 34% of the district. They include 95,200 children and 27,200 seniors. Another 53,500 are adults covered through the expansion. The federal dollars being cut cover their doctor bills, medicines and hospital care.
- The law leaves 300,000 more North Carolinians without insurance by 2034. KFF projects the law alone adds 300,000 uninsured North Carolinians in 2034. Its range runs between 220,000 and 370,000. The state's uninsured rate rises 3 points. People without coverage pay for care themselves or go without it.
- A quarter-million North Carolinians could be dropped from Medicaid from 2027. The law's changes could cost as many as a quarter-million people in the state their Medicaid starting in 2027, WRAL found in May 2026.
- North Carolina's hospital payment program loses $32 billion, and expansion is at risk. The law's provider-tax limits cost the state and its hospitals the benefit of the HASP payment program. The North Carolina Medical Journal puts the loss at about $32 billion in federal money over a decade. State law ends expansion coverage if hospital assessments cannot fully pay the state's share. Expansion added more than 685,000 people to NC Medicaid.
- Rural North Carolina's federal Medicaid money drops $6.37 billion in a decade. KFF pegs rural North Carolina's ten-year federal Medicaid loss at $6.37 billion, money that would have paid for Medicaid patients' care in the state's rural areas.
Frequently Asked Questions About Greg Murphy on Health Care
What is Greg Murphy's record on health care under Trump?
Greg Murphy voted for the One Big Beautiful Bill Act twice, first in May 2025 and then in July. His May vote was decisive, because the House bill passed by one vote. Federal Medicaid spending falls $911 billion under the final law, the Congressional Budget Office says. North Carolina's share is $22.5 billion, KFF calculates.
Did Greg Murphy vote for Medicaid work requirements?
Yes, Greg Murphy voted on July 3, 2025 for the law that created them. Expansion adults must document 80 hours a month. Jobs, community service, work programs and half-time school count. States must start the rule "no later than January 1, 2027." In North Carolina's 3rd District, 53,500 expansion adults were on Medicaid in 2025.
Did Greg Murphy vote to cut payments to North Carolina hospitals?
Yes, Greg Murphy's final-passage vote on July 3, 2025 went to the law's limits on state-directed payments, after his deciding budget votes set the Medicaid committee's savings target. KFF finds $3.44 billion a year of federal spending on hospital care in North Carolina exceeds those caps. The state's HASP rates "will begin to phase down by 10% per year beginning on July 1, 2028," the North Carolina Medical Journal reported. The provider-tax cap also drops in steps until "settling at a new cap of 3.5% on October 1, 2031."
Last updated: 2026-10-27