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SB 405 · 2025-2026 · Introduced in Senate

Held by House Clerk on 10/23/2025

Healthcare Investment Act.

Misleading 4/5Stowaway

SB 405 started as a chiropractic licensing and acupuncture certification bill. It passed the Senate as a chiropractic bill. Then the House gutted the entire thing and replaced it with emergency Medicaid funding provisions... increasing Medicaid appropriations from $600 million to $690 million recurring, plus $49.2 million for managed care.

This is a shell bill, but not the usual kind. Usually the legislature uses a shell to sneak something controversial past voters. Here, the House used a chiropractic shell to pass emergency healthcare funding. It passed 110-0. Every single member. In a legislature that can't agree on what day it is, 110 people voted yes on this.

The Senate killed it anyway. Not because they opposed it... but because the adjournment resolution said it wasn't on the pre-agreed list of eligible legislation. A procedural technicality during a $319 million Medicaid funding crisis. DHHS had already started cutting provider rates. Governor Stein urged the Senate to act. Speaker Hall accused the governor of manufacturing the crisis. Meanwhile the bill sat there, dead on arrival, 110-0 and going nowhere.

The title... "Healthcare Investment Act"... is spin on top of the shell. "Investment" is a generous word for a bill that included significant budget offsets and position cuts alongside the funding. But the bigger story is that 110 legislators agreed on something important, and the procedural machinery killed it.


Status

Held by House Clerk on 10/23/2025

Sponsors

Hise, Sawrey, Burgin


Stowaway Provisions

A bill that started as simple chiropractic licensing reforms was completely replaced with major healthcare budget cuts and Medicaid restructuring, appearing to use the innocuous original title to avoid scrutiny of controversial funding reductions.

The bill's stated purpose: Originally about modernizing chiropractic licensing requirements and Board composition

What was hidden inside: The House committee substitute completely replaced the chiropractic content with: $33.9 million in DHHS budget cuts and position eliminations, $14 million reduction in mental health Single Stream Funding, elimination of the Prescription Digital Therapeutics Pilot Program, $42.2 million reduction in Future Building Reserves, mandatory intergovernmental transfers from LME/MCOs, and extensive Medicaid program restructuring

Sources

ncleg.gov bill pagethecentersquare.com Center Square (110-0 passage, adjournment resolution ineligibility, Hall quote)sanfordherald.com Sanford Herald ($49.2M recurring managed care funding, $1M auditor review)medicaid.ncdhhs.gov NC Medicaid (funding shortfall context, provider rate cuts)UNC Legislative Reporting Service UNC School of Government (bill summary)ncleg.gov Original chiropractic versionncleg.gov Final Medicaid version

The Vote

10/22/2025 2:42 PM · Healthcare Investment Act. Second Reading · House

House Vote · Passed 1100

R Yea (62)D Yea (48)Absent (1)

Passed 110-0

Party Breakdown

R
62/71 (87%)
D
48/49 (98%)

4/30/2025 4:32 PM · Chiropractic Mods. Second Reading · Senate

Senate Vote · Passed 3511

R Yea (29)D Yea (6)D Nay (11)

Passed 35-11

Party Breakdown

R
29/30 (97%)
D
6/20 (30%)