“Medicaid really is a foundational pillar of hospital financing in the U.S., particularly for those hospitals that serve low-income, elderly or disabled populations across the country,” said Alan Condon, the editor-in-chief of Becker’s Healthcare, a health care business news publication.

Low-income green card holders still within the mandatory five-year waiting period for Medicaid would be among those most affected.

President Trump signed his one 'big, beautiful bill' on Friday, setting the stage for trillions of dollars worth of tax and spending policy. In North Carolina, the bill is likely to have a big impact on everything from Medicaid expansion and food stamps to the 2026 Senate election and state politics.