June 22, 2026
Old North State Report – June 19, 2026
UPCOMING EVENTS
- June 22: Thinkers Lunch: A Look at NC’s Economic Development Efforts
- July 15: North Carolina Healthcare Association Summer Meeting
- October 15: 2026 NC Professional Lobbyists Association Annual Meeting
- October 22: Association of Executives of North Carolina 2026 Fall Conference
LEGISLATIVE NEWS
NC LEGISLATORS SIGNAL PROGRESS TOWARD PASSING STATE BUDGET
North Carolina legislative leaders say they are making progress toward finalizing a state budget as House and Senate Republicans work through remaining items. House Speaker Destin Hall and Senate leader Phil Berger met this week to discuss unresolved issues, a step that is typically taken near the end of budget negotiations. Both leaders indicated that while work remains, negotiations are moving forward, and an agreement is achievable by the end of June.
The proposed budget is being built around a framework announced in May that ended a prolonged budget impasse. That framework includes state employee and teacher pay raises, future tax cuts, and plans to place constitutional amendments related to tax limits on the November ballot. Lawmakers also confirmed that the budget will include additional funding for Hurricane Helene relief. Budget negotiations are largely taking place behind closed doors, but legislative leaders say progress is steady.
Budget writers emphasized that compromises were necessary and that decisions were made jointly between the House and Senate. If approved, the budget would mark the state’s first comprehensive spending plan since 2023.
Newsline (Bonner) June 17, 2026
NORTH CAROLINA FORMS BIPARTISAN AI CAUCUS TO LEAD INNOVATION AND RESPONSIBLE POLICY
North Carolina has officially launched its first Artificial Intelligence (AI) Caucus, a bipartisan and bicameral group aimed at shaping the state’s future in AI. Led by key lawmakers from both parties, the caucus will focus on developing thoughtful policies that promote innovation, workforce readiness, and ethical AI use.
The initiative seeks to position North Carolina as a national leader in AI by supporting research, strengthening the economy, and preparing students and workers for an AI-driven future. It will also emphasize expanding digital literacy, protecting consumers, and examining AI’s impact on sectors like healthcare, public safety, and employment.
The caucus plans to collaborate with industry experts, educators, and community leaders to ensure AI development benefits all residents while maintaining transparency, public trust, and human autonomy. Overall, the effort reflects a commitment to balancing technological progress with responsible governance.
Hawkins in the House/Substack June 11, 2026
NORTH CAROLINA SENATE BILL PROPOSES CAP ON HOSPITAL CEO PAY
A bill introduced in the North Carolina Senate would limit how much hospital CEOs can be paid if their health systems receive state funding. The proposal aims to curb rising healthcare costs by tying executive compensation to a multiple of the average worker’s pay, arguing that excessive CEO salaries contribute to higher hospital expenses for patients.
Supporters say Senate Bill 978 promotes accountability and fairness, especially as hospitals benefit from public dollars while many patients struggle with affordability. Opponents, including hospital groups, argue the cap could make it harder to attract experienced leadership and could negatively impact hospital operations, particularly in rural areas.
The legislation has sparked debate over balancing cost control, executive compensation, and maintaining a strong healthcare system, with its future dependent on negotiations within the General Assembly.
NORTH CAROLINA LAWMAKERS RENEW PUSH TO STUDY PSYCHEDELIC-ASSISTED THERAPY FOR PTSD
North Carolina lawmakers are revisiting efforts to prepare the state for the possible medical use of psychedelic-assisted therapies through Senate Bill 1018. The bill would not legalize psychedelics or change current drug laws but instead create a task force to study their potential therapeutic use—particularly for veterans, first responders, domestic violence survivors, and others living with PTSD and trauma-related conditions.
The bipartisan proposal comes amid growing national attention and recent federal actions aimed at accelerating research into substances such as psilocybin and MDMA. Supporters argue that traditional treatments have fallen short for many trauma survivors, especially veterans, and say the state should be ready if the FDA approves these therapies.
If approved, the bill would provide up to $5.4 million in one-time funding for research and administration. Medical experts and veterans testified that psychedelic-assisted therapy has shown promise, while lawmakers emphasized that the effort is focused on research, safety, and preparedness—not legalization. The bill’s future remains uncertain, but supporters see it as a cautious first step toward mental health innovation in North Carolina.
SENATE ADVANCES MEDICAID OVERSIGHT BILL
North Carolina lawmakers are advancing a rewritten version of House Bill 34, aimed at strengthening the state’s ability to detect and prevent Medicaid fraud as budget pressures grow. The bill incorporates recommendations from the North Carolina Department of Health and Human Services and is moving through the Senate with limited debate. Legislators argue that improved fraud detection could save the state tens of millions of dollars, a priority as inflation, tax cuts, and population growth strain the state budget. Medicaid remains one of North Carolina’s largest expenses, covering more than 3 million residents.
A major focus of the bill is the rapid rise in spending on autism therapies, particularly applied behavioral analysis (ABA), which lawmakers say has become vulnerable to fraud. State spending on ABA has surged from $1.9 million to over $505 million in five years, driven in part by out‑of‑state telehealth providers entering the market. The bill would tighten rules for autism‑related services and create a more controlled provider network.
WRAL News (Doran) June 17, 2026
NC PREPARES FOR MAJOR OVERHAUL OF STATE EMPLOYEE HEALTH PLAN
North Carolina officials are preparing for significant changes to the state employee health plan, with a key board meeting expected to shape the plan’s future structure. The plan, which covers hundreds of thousands of state employees and retirees, is under pressure due to rising healthcare costs and long-term financial sustainability concerns. Leaders have described the upcoming decision as one of the most consequential in the plan’s history
Proposed adjustments could include changes to premiums, benefits, or administrative structure as officials look for ways to control costs while maintaining coverage quality. The outcome could have wide-reaching implications for both employees and the healthcare providers that serve them. This development highlights ongoing challenges states face in managing large healthcare systems amid inflation and increasing demand for services.
News & Observer (Guinassi) June 18, 2026
LATEST POLLS
RealClear Polling: North Carolina Senate- Whatley v. Cooper
WHAT WE’RE LISTENING TO
Tying It Together with Tim Boyum
