Trump’s ‘big, beautiful bill’ is making a big, ugly mess in North Carolina | Opinion

Deputy Opinion Editor Paige Masten is covering the 2026 election for The Charlotte Observer and the Raleigh News & Observer.

Donald Trump and many of his fellow Republicans are proud of their “big, beautiful bill,” but in North Carolina, it’s shaping up to be a big, ugly mess.

One major piece of the One Big Beautiful Bill Act, passed by Congress last year, was the changes it made to Medicaid and the Supplemental Nutrition Assistance Program (SNAP). Those changes now fall on the state to implement, and it’s clear that it’s not going to be easy.

State and county officials told legislators last week that they may need more time and money to comply with the mandates, which include new Medicaid work requirements and more frequent eligibility checks. Those requirements create new administrative burdens and challenges. The state will have to hire and train more staff, update technology and create data systems to handle the new processes.

That costs money, of course, and while state health officials have identified a few potential funding mechanisms, they all require legislative approval. Officials said last week they need the funding by the end of March in order to successfully get the program up and running by next year.

But there’s no urgency to be found from Republican lawmakers, who say they probably won’t return to Raleigh until April. One GOP leader said last week that “it’s too fast, too much work to do, and I just don’t see how we can do it” in time.

The burdens that the One Big Beautiful Bill Act shifts onto states are immense. Much of Medicaid and SNAP administration is handled at the county level, and many counties are already strained under the current workload and don’t have the funds to manage even more unless they trim their budgets elsewhere. Kevin Leonard, executive director of the N.C. Association of County Commissioners, told lawmakers that the law “is one of the most significant unfunded mandates and one of the largest shifts of administrative and economic responsibility that our state and our counties have seen in generations.”

The bill also contains the largest-ever cut to SNAP funding, forcing states to bear more of the financial and administrative responsibilities of administering the program. It also will require states to pay a percentage of the SNAP benefit costs if they make too many payment errors. According to ProPublica, North Carolina will likely have to start paying out an estimated $420 million annually in SNAP benefits under its current error rate. That means that the share of the state budget required to fund SNAP could rise by 352% in North Carolina, an analysis from the Georgetown University Law Center estimates.

It’s a mess, and anyone could have seen it coming. State health officials have been saying for months that the legislation will have significant consequences that the state will have to help mitigate.

U.S. Sen. Thom Tillis saw it coming, which is why he opposed the bill, warning the increased costs from work requirements and more frequent eligibility checks could trigger the end of Medicaid expansion, thanks to a provision in the law that ends expansion if the state has to pick up any more costs.

Even the legislature saw it coming. Upon announcing his support for the legislation last year, Senate leader Phil Berger promised “the legislature will work through any implementation issues,” but any progress toward that goal has been nonexistent so far.

Politically, it’s going to be a particularly big mess for Republicans, who will bear responsibility for any potential disruptions to, or termination of, benefits. That’s primarily the case for congressional Republicans who voted for the legislation. Some Republican members of Congress have a higher percentage of constituents who rely on Medicaid and SNAP, so any loss of benefits could affect their districts deeply.

That, too, is something Tillis warned about, reportedly telling colleagues “it could cost us majorities in both houses” of Congress. It is, after all, an election year. Republicans in Washington surely anticipated this — it’s why the harshest effects of the bill won’t be felt until after the midterms. But they didn’t do anything to try to stop it. State lawmakers could be on the receiving end of voters’ frustration, too, if they don’t do their part to keep the programs intact.

The cuts in the One Big Beautiful Bill Act may generate some savings at the federal level, but those costs haven’t gone anywhere. They’ve simply been passed along to the states, who now are scrambling to implement the changes without hurting those who depend on these programs to survive. But in North Carolina, hundreds of thousands of people could lose coverage anyway, whether it’s due to a lack of funding or simply because the system is now too difficult for them to navigate. There’s nothing remotely beautiful about that.

This story was originally published January 20, 2026 at 5:00 AM with the headline "Trump’s ‘big, beautiful bill’ is making a big, ugly mess in North Carolina | Opinion."