More than 35,000 jobs in North Carolina at risk under potential federal cuts, new report says

North Carolina could lose more than 35,000 jobs stemming from potential cuts to Medicaid and the Supplemental Nutrition Assistance Program, according to a report by the Commonwealth Fund released Tuesday morning.

The Commonwealth Fund, a health care foundation focused on underserved communities, partnered with George Washington University’s Milken Institute School of Public Health to analyze the potential state-by-state impacts of a congressional budget plan that is widely expected to require cuts to Medicaid and other federal aid programs like SNAP, colloquially known as “food stamps.”

The report found significant impacts to state revenue and local economies, projecting the loss of more than a million jobs across the U.S. in 2026, including 35,500 jobs in North Carolina. The state would lose out on more than $3 billion in federal aid under the projections, leading to a forecast hit of roughly $3.6 billion to the state GDP and more than $250 million in lost tax dollars.

Those projected losses result because the money from federal aid programs like Medicaid and SNAP flow directly into local economies, creating revenue for hospitals, grocery stores, and other local businesses, allowing them to create jobs for their communities. Without that revenue, the Commonwealth Fund report projects that these businesses would no longer be able to support tens of thousands of employees, further straining a job market still reeling from the mass layoff of federal employees.

“Medicaid and SNAP programs are not just designed to strengthen individual health and nutrition — they support the economic wellbeing of communities and businesses nationwide,” said Leighton Ku, the report’s lead author. “Such drastic reductions would harm millions of families and also trigger widespread economic instability and major job losses.”

While specific cuts to federal assistance programs have not been announced by the Trump administration, budget resolutions passed by the Republican-led Senate and House call for between hundreds of billions and trillions in cuts to federal spending, respectively. Tuesday’s report draws on the House figure, which calls for $880 billion in cuts by the House committee overseeing the Medicaid program and $230 billion by the committee that oversees SNAP.

The study describes a costly “ripple effect” in which loss of revenue to health care facilities and food providers triggers layoffs that further reduce economic activity in the affected communities, leading to further losses and layoffs that could inflict even more pain on a U.S. economy that is already showing signs of flagging.

Joseph Betancourt, president of the Commonwealth Fund, called Medicaid and SNAP “foundational to people’s health and well-being” and warned of a devastating economic impact should forecast cuts go through.

“Slashing these programs will worsen health outcomes for all Americans, and particularly for people with chronic conditions who rely on Medicaid for ongoing care. Similarly, cutting SNAP will push more families into financial distress, making it harder for them to afford basic necessities,” he said. “The ripple effect will hit the entire health care system and impact everyone — not just those with Medicaid — driving more people to emergency rooms and further straining an already overburdened system.”