H655 - NC Health Care for Working Families

• Establishes "NC Health Care for Working Families" program providing health coverage to North Carolina residents aged 19-64 with income up to 133% of federal poverty level who are ineligible for Medicaid and not enrolled in Medicare.

• Requires participants to pay 2% of household income as monthly premiums, with suspension after 120 days of non-payment unless exempt due to poverty, medical hardship, financial hardship, Indian Health Services beneficiary status, or veteran transition status.

• Includes mandatory employment activities aligned with Supplemental Nutrition Assistance Program work requirements, with exemptions for primary caregivers, individuals in substance abuse treatment, medically frail persons, pregnant/postpartum women, and Indian Health Services beneficiaries.

• Program funding limited to federal funds (90% federal matching rate), participant premiums, and state/county funds from intergovernmental transfers, gross premiums tax revenue, and hospital assessments.

• Establishes North Carolina Rural Access to Healthcare Grant Fund with $25 million (2020-2021), $30 million (2021-2022), and $50 million annually thereafter for rural health initiatives including provider recruitment, loan forgiveness, telehealth expansion, opioid abuse combat, and mental health services.