North Carolina Sen. Ford’s Medicaid eligibility revision bill passes House and Senate

Passed bill sponsored by State Sen. Carl Ford seeks to align Medicaid eligibility rules with federal law, ensuring asset transfers to pooled special needs trusts do not affect benefits for seniors, according to the North Carolina State Senate.

In the House, 45 Democrats and 65 Republicans voted in favor of the bill.

Meanwhile, in the Senate, 19 Democrats and 29 Republicans voted in favor of the bill.

Ford filed the bill in the North Carolina Senate on March 19 during the 2025 regular session.

The legislation, known as SB 344, was passed on June 18 during the 2025 regular session.

According to the North Carolina General Assembly site, the bill’s official text was formally listed with the short title: “Pooled Trust Transfers/Public Benefits Elig.”

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 to revise its Medicaid and State-County Special Assistance eligibility rules for individuals 65 and older. It ensures that transferring assets into a pooled special needs trust, compliant with federal guidelines, is considered a fair market value transfer, thereby not affecting eligibility for these benefits. The transferred funds must be intended for use by the trustee to provide goods and services equal to the funds’ fair market value within the individual’s life expectancy. The changes align state policies with federal law to prevent financial penalties for such asset transfers by seniors. The act becomes effective upon enactment.

The bill was sponsored by Sen. Carl Ford (Republican-33rd District), Sen. W. Ted Alexander (Republican-44th District), and Sen. Amy S. Galey (Republican-25th District).

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.

Ford, a Republican, was elected to the North Carolina State Senate in 2019 to represent the state’s 33rd Senate district, replacing previous state senator Cathy Dunn.

Under North Carolina law, bills must receive three readings in each chamber. According to the UNC School of Government, once a bill “passes its constitutionally required second reading and moves to its constitutionally required third reading,” additional debate can occur, but the final stage is often treated as a formality. Unless a legislator requests a roll-call, the third reading may be approved by voice vote or unanimous consent without a separate recorded tally.