Rep. Brad Knott voted for the One Big Beautiful Bill Act, which cut $1 trillion from Medicaid over ten years, imposed work requirements that could strip coverage from nearly 500,000 North Carolinians in the Medicaid expansion population, and let enhanced ACA premium subsidies expire — driving a 28.6% average premium spike for the nearly one million North Carolinians on ACA plans. Knott also voted against extending ACA subsidies and refused to comment on the vote. Meanwhile, Knott collected over $84,000 from health care industry and insurance PACs, including $7,500 from Pfizer alone. When constituents pressed him on rural hospital closures at a town hall, Knott offered only vague assurances that Congress would act "if there are emergencies," even as Governor Stein warned the bill puts five North Carolina hospitals at risk of closure. NC Health News could not find a single public statement from Knott's campaign addressing Medicare, Medicaid, rural hospital funding, or prescription drug costs.
Knott Voted For The One Big Beautiful Bill Act, Which Cut $1 Trillion From Medicaid Over Ten Years. According to WUNC, Knott acknowledged constituent worries about rural hospital closures due to Medicaid funding reductions in Trump's tax and spending bill, but said the Medicaid provisions "won't take effect for two years, giving lawmakers time to address any problems," adding, "'We allocated tens of billions of dollars if there are emergencies in rural healthcare spheres and spaces.'" The bill passed the House 218-214 on July 3, 2025. [WUNC, 9/19/25]
Governor Stein Warned The Bill Could Cause Five North Carolina Hospitals To Close. According to a press release from Governor Josh Stein, "This reconciliation bill would undo decades of bipartisan progress and harm the health, well-being, and economic security of people, families, and communities in our state." Stein estimated 520,000 North Carolinians could lose health insurance under the bill. [Office of the Governor, 7/2/25]
The Bill Imposed Medicaid Work Requirements That Could Strip Coverage From 496,000 North Carolinians. According to the NC Budget and Tax Center, the bill "creates more red tape and barriers to coverage through harsh new Medicaid work requirements" that could leave 496,000 North Carolinians in the expansion population without health coverage. [NC Budget and Tax Center, Viewed 2/16/26]
North Carolina's Medicaid Director Said Work Requirements Would Likely Undo The State's Medicaid Expansion. According to NC DHHS, expansion-eligible adults must "work or participate in qualifying activities [...] for at least 80 hours per month or attend school at least half-time" beginning January 1, 2027, with eligibility redetermined every six months instead of annually. The state's Medicaid director indicated the combination of work requirements and lower provider tax caps will likely undo the Medicaid expansion North Carolina lawmakers approved in 2023. [NC DHHS, Viewed 2/16/26]
Knott Voted Against Extending ACA Subsidies And Refused To Comment. According to NC Health News, U.S. Reps. Chuck Edwards, Brad Knott, and Tim Moore voted against extending ACA subsidies, and "none responded to requests for comments on their votes." [NC Health News, 1/19/26]
ACA Premiums In North Carolina Spiked An Average Of 28.6% After Subsidies Expired. According to a press release from the NC Department of Insurance, Insurance Commissioner Mike Causey stated, "'Increased costs in healthcare as well as the expiration of federal subsidies result in premiums going up for many on the individual market.'" Individual ACA rates increased between 16.88% and 36.4% in 2026. [NC Department of Insurance, 10/29/25]
220,000 Fewer North Carolinians Enrolled In ACA Plans After Subsidies Expired. According to NC Voices, nearly 900,000 North Carolinians received the enhanced premium tax credit in 2025, averaging $574 monthly in subsidies. After the subsidies expired, ACA sign-ups plunged by 22%, with 220,000 fewer residents enrolling in 2026. An estimated 157,000 residents risk losing ACA coverage entirely due to higher costs. [NC Voices, Viewed 2/16/26]
A Charlotte Couple's ACA Premium Could Rise From $7,225 To $31,446 Per Year. According to NC Voices, a 62-year-old couple living in Charlotte with an ACA marketplace plan would see their annual premium rise from $7,225 to $31,446 — a more than fourfold increase. [NC Voices, Viewed 2/16/26]
Knott Accepted Over $57,000 From Pharmaceutical and Health Care PACs. According to FEC records, Knott accepted contributions from PACs affiliated with Pfizer ($7,500 across three contributions), Eli Lilly ($2,500), Novo Nordisk ($7,500), Amgen ($3,000), CVS Health ($1,000), Walgreens ($2,500), McKesson ($2,000), DaVita ($2,500), and the American Health Care Association ($1,000), among others. [FEC, Viewed 2/16/26]
Knott Accepted Over $26,000 From Insurance Industry PACs. According to FEC records, Knott accepted contributions from the Elevance Health PAC ($2,500), New York Life Insurance PAC ($3,500), Massachusetts Mutual Life Insurance PAC ($2,500), the National Association of Insurance and Financial Advisors PAC ($2,500), and others. [FEC, Viewed 2/16/26]
NC Health News Could Not Find Any Public Statements From Knott On Key Health Care Issues. According to NC Health News, the outlet "attempted to contact Knott's campaign multiple times but received no response" and "was unable to find public statements" from Knott addressing Medicare, Medicaid time limits and work requirements, rural hospital funding, health care and pharmaceutical cost control, or mental health services and the opioid crisis. [NC Health News, Viewed 2/16/26]
A North Carolina Woman's Monthly ACA Premium Doubled From $975 To $1,945. According to NC Voices, beneficiary Lea Charlton said, "'My premium skyrocketed from $975 a month to $1,945 a month.'" [NC Voices, Viewed 2/16/26]
North Carolina Medicaid Providers Stopped Accepting Patients Amid Funding Crisis. According to a press release from Governor Stein, the state's Medicaid funding shortfall forced rate cuts of 3% to 10% for doctors, hospitals, and other medical providers beginning October 1, 2025, and "some providers have made the difficult decision to stop taking Medicaid clients." The rate cuts threatened the ability of many practices to keep their doors open and continue serving patients. [Office of the Governor, 12/10/25]
A North Carolina Family Of Four Could See Monthly ACA Costs Jump From $250 To $600 Or More. According to Blue Cross NC, families previously paying $250 a month through ACA plans could see their bill jump to $600 a month or more in 2026 after subsidies expired. [Blue Cross NC, Viewed 2/16/26]