Sen. Craven files bill in North Carolina Senate to expand Medicaid eligibility

A new bill filed by Sen. Craven seeks to expand Medicaid eligibility for personal care services to individuals in licensed adult care homes with incomes above current program limits, according to the North Carolina State Senate.

The bill, filed as SB 699 on March 25 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, Division of Health Benefits, to seek federal approval to extend Medicaid eligibility for personal care services to individuals residing in licensed adult care homes and special care units. These individuals must have incomes exceeding the limit for participation in the State-County Special Assistance Program but not exceeding 180% or 200% of the federal poverty level, depending on whether they would qualify for basic or enhanced assistance rates. The bill requires the cost of the new Medicaid coverage to be offset by savings or cost avoidance and mandates compliance with legal requirements. The department is directed to submit a request to the Centers for Medicare and Medicaid Services (CMS) within 90 days of enactment, implementing the coverage only upon CMS approval and goal fulfillment. The bill becomes effective immediately upon becoming law.

Of the three sponsors of this bill, Benton G. Sawrey proposed the most bills (56) 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.

Craven graduated from the University of North Carolina Charlotte in 2012 with a BA.

Craven, a Republican, was elected to the North Carolina State Senate in 2023 to represent the state’s 29th Senate district, replacing previous state senator Steven Jarvis.