NCDHHS releases toolkit to help people navigate changes to SNAP and Medicaid
The federal budget reconciliation bill, also called H.R. 1, reduced federal funding for SNAP by $186 billion through 2034, which amounts to a roughly 20% cut — the largest in Supplemental Nutrition Assistance Program (SNAP) history. These changes could have serious effects on food access for North Carolinians — impacting who qualifies for the program and which children are automatically eligible to receive free or reduced-price school meals.
The same bill also made significant changes to the funding and administration of Medicaid, which will impact who qualifies for the health insurance program and how much they pay.
To help people navigate and understand these changes, the N.C. Department of Health and Human Services (NCDHHS) has put together a number of resources, including a landing page with important information and communication tools.
“These tools can help communities better understand what is changing and connect people with information and support to help them maintain access to benefits,” said the Blue Cross and Blue Shield of North Carolina Foundation in an email to EdNC and other grantees.
Explore the page on navigating the changes to SNAP here and the changes to Medicaid here. (Haz clic aquí para explorar los recursos de Medicaid en español, y aquí para recursos de SNAP.)
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Changes to SNAP work requirements
SNAP is a federal nutrition assistance program that provides food benefits to low-income families, helping them pay for groceries. As of 2025, more than 1.4 million people in North Carolina, including roughly 600,000 children, received SNAP benefits each month — bringing roughly $2.8 billion in federal funds annually to North Carolina and generating a $4.2 billion impact, according to previous reporting by EdNC.
H.R. 1 expanded who must work and how much they must do so to qualify for SNAP; those changes went into effect on Dec. 1, 2025. According to NCDHHS, the expanded work rules related to SNAP fit into two categories: General Work Registration (for individuals between the ages of 16 and 59) and Able-Bodied Adults Without Dependents (ABAWD) Time Limits (for individuals between the ages of 18 and 64).
“Most adults receiving SNAP benefits must follow general work rules. However, a specific group of recipients (referred to as able-bodied adults without dependents, or ABAWD) have a time limit on their benefits if they are not meeting work requirements,” says NCDHHS’s website.
However, many people qualify for exemptions to this new rule. For example, if you live in a household with a child under 14 years old, even if the child isn’t yours, you qualify for an exemption. Other exemptions are available for individuals who are pregnant, domestic violence survivors, experiencing chronic homelessness, and more. You can explore the exemptions for ABAWD work rules here.
Individuals subject to ABAWD work rules must work 80 hours per month, or about 20 hours a week, which can include volunteering or other approved activities. If you do not have an exemption and do not meet these new work requirements, you can only receive three months of SNAP benefits over a 36-month period (January 2025 to December 2027).
NCDHHS has published tools to help people navigate the new rules, outlining the process of understanding how the new structure might affect them. The guide explains:
- Your caseworker will screen you for exemptions.
- For many exemptions, your statement is generally accepted.
- You get time to provide proof.
- Missing hours doesn’t always count against you.
- You can ask for help.
Explore more about the new SNAP work requirements here. Read more about the cuts made to SNAP in H.R. 1 here.
More EdNC coverage of changes to SNAP
Navigating changes to Medicaid
Medicaid is a joint federal-state program that provides “healthcare to eligible low-income adults, children, pregnant women, seniors and people with disabilities.” One in four North Carolinians get their health insurance through Medicaid, with half of all births in the state being covered by the program, too.
According to NCDHHS, the program contributes $30 billion to North Carolina’s economy, and 98% of Medicaid expenditures in North Carolina go to services and providers across the state.
There are several changes to Medicaid that might affect coverage for North Carolinians. Effective Jan. 1, 2027, for people 19 to 64 years old, “Medicaid will require you to work, go to school or volunteer 80 hours a month.” In order to meet the requirement, “You must show proof of the time you worked and the money you made.” You also must renew your Medicaid coverage every six months instead of once a year.
Furthermore, many people who are not U.S. citizens will lost their coverage. The rule goes into effect Oct. 1, 2026. Read more about if this rule effects you here.
For people who are newly applying to Medicaid, you may apply for “retroactive coverage” of healthcare for up to one month before you applied, which is a shorter time frame than was previously covered. However, if you apply by Dec. 31, 2026, Medicaid will cover approved costs for up to three months before you applied.
NCDHHS encourages everyone who has NC Medicaid to check their coverage, saying users should:
Check that your local Department of Social Services (local DSS) has your current address and phone number. They will write to you about these changes. If your address is wrong, you could lose your Medicaid without knowing why. Update your address online at ePASS or call your local DSS.
Answer any letter right away. Letters from your local DSS usually have a deadline. Missing a deadline is a common reason people lose their Medicaid.
Get an enhanced ePASS account if you do not have one. You need an enhanced account to upload any documents you may need to share to keep your Medicaid coverage.
More on healthcare in NC
Additional ways to support Medicaid enrollment
The Blue Cross NC Foundation compiled a list of additional ways “organizations interested in expanding their ability to support Medicaid enrollment” could consider participating in:
Become a Medicaid Ambassador — NCDHHS can train volunteers to help people apply for Medicaid through ePASS.nc.gov and HealthCare.gov.
Sign up for Train-the-Trainer — NCDHHS can train organizations to run their own info sessions and point people to the right Medicaid resources.
Join the Connecting Communities and Medicaid (CCM) Workgroup — Opportunity to connect with a statewide group of organizations working on Medicaid access and HR1 changes. Meets virtually the second Wednesday of each month at 8:30 a.m.
Editor’s note: The Blue Cross and Blue Shield of North Carolina Foundation supports the work of EdNC.