More than 660,000 North Carolinians are projected to lose their healthcare coverage under the Trump GOP's "One Big" federal budget, which Congress passed the other week. The cuts to Medicaid will be felt in every single county across the state, with particularly heavy losses in rural counties.

The claim breaks down into several components: the number of North Carolinians projected to lose healthcare coverage, the attribution of this loss to Medicaid cuts under the Trump GOP's 'One Big Beautiful Bill' federal budget, and the geographic distribution of these losses across all counties with heavier effects in rural areas. Multiple reputable sources, including analyses by the Kaiser Family Foundation (KFF) and North Carolina Health News, confirm that the reconciliation package known as the 'One Big Beautiful Bill Act' includes substantial Medicaid cuts that would increase the uninsured population significantly in North Carolina.

Estimates from KFF and state-focused reporting indicate that more than 660,000 people in North Carolina could lose coverage, consistent with the claim. The impact is expected to be statewide, affecting every county, with rural counties facing particularly severe consequences due to hospital closures and reduced access to care. While exact numbers vary slightly depending on modeling assumptions and timing, the scale and distribution described align well with authoritative projections.

The claim’s reference to Congress passing the budget 'the other week' is consistent with recent legislative activity in mid-2025. Some sources project even higher national coverage losses (up to 12 million), but the state-specific figure cited is supported by detailed state-level analysis. Overall, the claim is largely accurate though precise figures may vary as final legislation details evolve and implementation unfolds.