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Public Policy Blog

Public Policy Update - September 29, 2025

September 29, 2025

Read a summary of recent public policy updates that may be of interest to North Carolinians with intellectual and other developmental disabilities (I/DD). These updates are current as of September 29, 2025.

State Update

As reported in the August Highlights & Hot Topics newsletter, in response to the shortfall for Medicaid Rebase in the mini-budget that was passed by the legislature, an announcement came out on August 11, 2025, from the North Carolina Department of Health and Human Services (DHHS) Secretary Sangvai, indicating the following cuts, which are set to take place on October 1, 2025:

  • Rate reductions of 3% across all providers, including Innovations
  • Rate reductions of 8% Personal Care Services in CAP-DA and CAP-C, 3% other CAP services
  • Rate reductions of 8% for ICFs
  • Rate reduction of 10% for inpatient, PRTFs, RB-BHT (intervention for autism)
  • Elimination of certain services altogether – GLP-1 treatment for obesity

The week of September 22, 2025, legislators returned for a three-day legislative session and both the Senate and House passed bills that would appropriate $690 million for the Medicaid Rebase. The Senate bill also included funding for a children’s hospital which was not a part of the House bill. The Senate and House were unable to come to an agreement so neither of the bills made it to the Governor’s desk for a signature.

On September 25, 2025, the Governor held a press conference where he announced that, without additional funding, the proposed Medicaid cuts would take effect on October 1, 2025, with a 45-day implementation timeframe. In order to change rates, DHHS is required to submit a state plan amendment to the Centers for Medicare and Medicaid (CMS). Following the press conference, the LME/MCOs indicated that they will not implement the reductions until November 1, 2025.

These timelines left an opportunity for continued education and advocacy about the effects of the proposed cuts. Since DHHS indicated that if the $690 million is approved, there will be no need to reduce rates, there is hope that when the legislature returns in late October there can be an agreement reached between the Senate and House so that rate cuts can be avoided.

The upcoming legislative sessions are:

  • October 20-23, 2025, at 10 a.m.
  • November 17-20, 2025, at 10 a.m.
  • December 15-18, 2025, at 10 a.m.
  • January 12-15, 2026, at 10 a.m.
  • February 9-12, 2026, at 10 a.m.
  • March 9-12, 2026, at 10 a.m.
  • April 6-9, 2026, at 10 a.m.
  • April 21, 2026 (Short Session begins), at 12:00 noon

Federal Update

Budget

The federal fiscal year ends September 30, 2025 and there has been no agreement between the House and Senate on a budget. Congress has been working to pass a continuing resolution (CR), a bill that would temporarily fund the federal government while they continue to work on a budget for the year which begins October 1, 2025. On September 19, 2025, the House of Representatives passed a continuing resolution to fund the government through November 21, 2025 by a vote of 217-212, which the Senate voted down, 44-48. Both the House and Senate were on recess the week of September 22nd – 26th and the President recently cancelled a meeting with Democrats to discuss a way forward on funding the government. With only a couple of days left to come to an agreement, there is a significant risk of a federal government shutdown.

Supplemental Nutrition Assistance Program (SNAP)

In addition to the cuts to Medicaid in HR1/Reconciliation bill that have been described in the last two Highlights & Hot Topics newsletters, the reconciliation bill includes devastating cuts to SNAP, which will reduce food assistance for millions of people, including some people with IDD. The $187 billion cut to SNAP over the next decade (according to the Congressional Budget Office) is the largest cut to SNAP ever enacted. This creates a cost-shift to states, which requires states to pay a share of SNAP benefits or be forced to drop out of SNAP entirely. This also creates pressure for our state to find additional funding which could lead to additional cuts in other areas.

In Congress, Senator Lujan, Senator Klobuchar, Representative Hayes and Representative Craig are looking for co-sponsors for a bill titled “Restoring Food Security for American Families and Farmers Act of 2025”. This bill would repeal all the SNAP cuts in HR1.

Autism in the News

On September 22, 2025, the President, the federal DHHS Secretary, and other federal DHHS leaders held a press conference with announcements aimed at “reversing the autism epidemic.” Many of the announcements made are misleading, disrespectful, and promote stigma. Several leading national organizations responded with statements addressing these concerns. This is the statement from the National Association of Councils on Developmental Disabilities:

Autistic people deserve respect and support. There are many policy and program changes HHS could pursue that would materially improve the lives of autistic people and our families.

Below are links to organization statements that reinforce the need for accurate representation of research and promote the dignity of people with autism.