A provision in the $319 million Medicaid funding bill that passed the General Assembly on April 22 is reopening a familiar fight over which of North Carolina’s executive branch offices should police fraud in the program.
State House Minority Leader Robert Reives, D-Chatham, called the provision “an electoral document” at a press conference hours before he voted to pass the bill.
HB 696, which allocates $319 million to cover the state’s Medicaid shortfall for the remainder of the fiscal year, passed the House 112-1 and the Senate 48-1. The lone vote against the measure in the House came from state Rep. Pricey Harrison, D-Guilford.
The bill also directs State Auditor Dave Boliek, a Republican, to conduct a performance audit of Medicaid and provides his office with $500,000 to do so.
“That is an electoral document if you’re passing those duties as state auditor,” Reives said at an April 22 press conference. He argued that the auditor already has “plenty of duties” on top of authorities transferred from the governor’s office since Democrat Josh Stein took office in January 2025.
“The state auditor now has one-and-a-half jobs,” Reives said. “Now you’re talking about making [the auditor] the attorney general also. So then that makes it two jobs.”
Reives pointed to a House Select Committee on Oversight and Reform hearing on April 16, at which Attorney General Jeff Jackson said North Carolina ranks eighth nationally in total Medicaid fraud recoveries over the past six years. Jackson requested partial funding for one additional data-mining investigator in his office’s Medicaid Fraud Investigation Division. That request was not funded in HB 696.
“If you hire, if you gave me one more staff member, I can cover whatever we need to cover,” Reives said, paraphrasing Jackson’s testimony. He argued the decision to route oversight money elsewhere was about who holds which office rather than capacity. “We want somebody that we know and we like to do it.”
Other Democratic leaders at the Wednesday press conference did not engage the auditor provision directly. Deputy Minority Leader Cynthia Ball, D-Wake, said House Democrats’ “top priority in the health care space is making Medicaid whole” and protecting the roughly 700,000 North Carolinians enrolled through expansion.
Conference Chair Vernetta Alston, D-Durham, and Legislative Chair Brandon Lofton, D-Mecklenburg, addressed cost of living and public education. Reives was the only caucus leader to speak to HB 696’s fraud oversight structure.
House Speaker Destin Hall, R-Caldwell, has framed the bill as a check on spending the Stein administration has allowed to run unchecked.
“Medicaid should serve the people who truly need it, and this bill makes sure that happens,” Hall said in a statement. “After Gov. Stein and his administration let costs run wild, we’re tightening things up by adding common-sense guardrails that cut down on waste, fraud, and abuse in the program.”
Senate Leader Phil Berger, R-Rockingham, addressed the decision not to fund Jackson’s additional staffer by telling reporters that “if he’s got enough staff to file lawsuits all over the country, then maybe he doesn’t need us to fund another one.”
Boliek, a first-term Republican elected in 2024, has already identified Medicaid-funded applied behavior analysis therapy as a target of his office’s scrutiny. At a March legislative meeting, Boliek told lawmakers there had been “a tremendous spike in the amount of money that Medicaid spends in that particular arena. Our team has begun a detailed look at that.”
Reives framed the fraud oversight dispute as part of a wider pattern of executive branch realignment since Democrats won the governor’s office and attorney general’s race in 2024. Duties have been shifted from the governor to the auditor, Reives said, and the legislature also cut the attorney general’s office by 15% after Jackson’s election.
Despite the criticism, Reives voted for the package and told reporters the caucus supported the funding piece.
“Right now we’re in triage,” he said. “Knowing that we’ve saved Medicaid to an extent right now is a win in my book.”
