McDowell Worked As A Lobbyist For Blue Cross Blue Shield Of North Carolina Until The Day He Launched His Congressional Campaign. According to NC Newsline, "McDowell was registered with the state as a lobbyist for Blue Cross Blue Shield of North Carolina until he resigned in 2023. [He] was only registered to lobby for the insurance company when he filed to run for Congress." McDowell resigned his lobbying registration on December 13, 2023 — the same day he announced his candidacy with a Trump endorsement. [NC Newsline, 3/14/24]
McDowell's First Major Fundraiser Was Hosted By Lobbyists And State Legislators, Drawing "Big Insurance" Criticism. According to Yahoo News, McDowell's January 2024 fundraiser in Raleigh — outside his own district — featured prominent state legislators including Senate President Pro Tempore Phil Berger and multiple lobbyists. A Republican primary opponent's consultant said, "'It appears safe to say Addison McDowell has chosen his allegiance and who he wants to represent.'" [Yahoo News, 1/30/24]
McDowell Also Lobbied For The North Carolina League Of Municipalities. According to Yahoo News, McDowell maintained lobbying registrations for both Blue Cross Blue Shield of North Carolina and the North Carolina League of Municipalities before resigning to run for Congress. [Yahoo News, 1/30/24]
McDowell Voted For The One Big Beautiful Bill's $1 Trillion In Medicaid Cuts — A Vote That Could Trigger An Automatic Rollback Of North Carolina's Medicaid Expansion. According to WFAE, North Carolina's 2023 expansion law "included a contingency: if federal funding drops below certain levels, the expansion automatically terminates." McDowell's vote threatens coverage for more than 670,000 North Carolinians who gained Medicaid in less than two years and could cost the state nearly $37.5 billion in federal funding over the next decade. [WFAE, 1/17/26]
McDowell Did Not Join The Bipartisan Effort To Extend ACA Subsidies, Then Voted Against A Procedural Motion To Force A Vote On The Extension. According to NBC News, only four House Republicans signed a discharge petition to force a vote on a three-year ACA subsidy extension. McDowell was not among them. According to ABC News, when the House voted on a procedural motion to force the vote in January 2026, nine Republicans joined Democrats — but McDowell voted against it. [NBC News, 12/17/25; ABC News, 1/8/26]
McDowell's Campaign Refused To Answer NC Health News' Health Care Questionnaire During The 2024 Campaign. According to NC Health News, when the outlet reached out to McDowell's campaign "for answers to their healthcare questions, they received no response." The questionnaire covered Medicare, pharmaceutical costs, Medicaid work requirements, rural hospital support, child care access, and pandemic preparedness. [NC Health News, Viewed 2/16/26]