Unless we fall at or below it by October 2027, North Carolina will incur a heavy penalty. All federal programs must be on the table for reevaluation, reform, and reduction. It means imposing time limits and work requirements on able-bodied recipients of Medicaid, SNAP, public housing, and other public assistance. But let’s be clear: our current model for Medicaid, SNAP, and the rest is already unfunded! To return to the North Carolina case, the General Assembly and the administration of Gov.