Rep. Sauls files bill in North Carolina House to extend Medicaid eligibility

A new bill filed by State Rep. John Sauls seeks to expand Medicaid coverage for personal care services to certain residents of licensed adult care homes and special care units, according to the North Carolina State House.

The bill, filed as HB 485 on March 24 during the 2025 regular session, was formally listed with the short title: ‘Adult Care Home Medicaid PCS Coverage.’

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, this bill mandates the North Carolina Department of Health and Human Services (DHB) to seek federal approval to extend Medicaid eligibility for personal care services to residents of licensed adult care homes and special care units. It targets individuals whose income is too high for the State-County Special Assistance Program but does not exceed 180% of the federal poverty level for basic rate eligibility or 200% for the enhanced rate. The bill emphasizes that any new Medicaid coverage should be financially offset by savings or cost avoidance. The DHB is required to consult with stakeholders and submit a compliant request to the Centers for Medicare and Medicaid Services within 90 days after the bill becomes law, implementing the coverage only upon approval and alignment with the specified objectives. The act takes effect immediately upon becoming law.

Of the two sponsors of this bill, Larry W. Potts proposed the most bills (21) during the 2025 regular session.

Bills in North Carolina follow a multi-step process before becoming law. A lawmaker starts by filing a bill, which is assigned to a committee for review. The bill must be read three times in each chamber. If one chamber changes the bill after the other passes it, both must agree on the final version. Once both chambers approve the same bill, it goes to the governor, who has 10 days (or 30 if the legislature is not in session) to sign, veto, or let it become law without a signature.

You can read more about the bills and other measures here.

Sauls, a Republican, was elected to the North Carolina State House in 2017 to represent the state’s 51st House district, replacing previous state representative Brad Salmon.