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Ex-Democrats hand North Carolina GOP key votes

Two Mecklenburg lawmakers helped Republicans advance constitutional amendments and override a veto.

Politics

Two former Democrats gave Republicans in the North Carolina House the three-fifths majority they needed for several votes Wednesday, passing a trio of constitutional amendments that will likely appear on ballots across the state in November.Why it matters: Charlotte state Reps. Carla Cunningham and Nasif Majeed having joined the Republican majority Wednesday may have long-term effects, given the high threshold for altering the state constitution.

North Carolina sues VinFast to take back control of Chatham County land

The lawsuit is meant to take back control of the Chatham County land VinFast wanted to build on.

Business

N.C. Attorney General Jeff Jackson is suing the Vietnamese car maker VinFast, alleging the electric vehicle company breached its agreement with the state to build a manufacturing facility in Chatham County. Why it matters: Announced with much fanfare in 2022, VinFast&#x27;s promise to build a $4 billion EV plant in Chatham County and employ some 7,500 workers has not materialized, according to the lawsuit. <ul><li>The lawsuit is part of an effort by the state to reacquire the 1,765-acre site from VinFast and begin marketing it to new companies. </li></ul>

Why a Raleigh church is rethinking its parking lot's future

Many churches across the country are now using excess land to add affordable housing.

News

One of Raleigh&#x27;s most historic churches, <a class="gtmContentClick" data-vars-link-text="Edenton Street United Methodist Church" data-vars-click-url="https://www.esumc.org/" data-vars-content-id="9115327a-afae-4966-bbd1-0316fa8cf9e6" data-vars-headline="Why a Raleigh church is rethinking its parking lot&#x27;s future" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.esumc.org/" target="_blank">Edenton Street United Methodist Church</a>, is contemplating the future of its downtown parking lot and how it can be best used going forward in a rapidly changing city. Why it matters: <a class="gtmContentClick" data-vars-link-text="The church&#x27;s 1.2-acre parking lot" data-vars-click-url="https://www.esumc.org/dawsonlot" data-vars-content-id="9115327a-afae-4966-bbd1-0316fa8cf9e6" data-vars-headline="Why a Raleigh church is rethinking its parking lot&#x27;s future" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.esumc.org/dawsonlot" target="_blank">The church&#x27;s 1.2-acre parking lot</a> sits in the heart of downtown Raleigh, where the church has been located since the early 1800s.

North Carolina Aquarium closing for yearslong expansion

The aquarium closes after Memorial Day for a renovation that will add a huge new shark habitat.

<figure><img alt="A shark moves through the screen, its multiple rows of teeth and dead-looking eye nearing the camera lens." height="450" id="10af9e22-a47b-481f-8ca1-65b5730e5a68" src="https://images.axios.com/WCIhcD3MIptV2oxxjZP1B4fDUy0=/2026/05/21/1779378719507.gif" width="800"/><figcaption>A sand tiger shark at Fort Fisher Aquarium. Video: Mary Helen Moore/Axios</figcaption></figure>This is the final weekend the North Carolina Aquarium at Fort Fisher will be open for several years. Why it matters: A lengthy renovation and expansion begins after Memorial Day that will give the already popular destination a new look and make it the state&#x27;s largest aquarium.Zoom in: Today, the aquarium is home to around <a class="gtmContentClick" data-vars-link-text="200 species" data-vars-click-url="http://inaturalist.org/guides/1499?page=1" data-vars-content-id="2a2d2d2e-f96d-4944-8fce-fdff17ba1be1" data-vars-headline="North Carolina Aquarium closing for yearslong expansion" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="http://inaturalist.org/guides/1499?page=1" target="_blank">200 species</a>, many native to North Carolina&#x27;s waters, including sand tiger sharks, an albino alligator and, sometimes, sea turtles. <ul><li>Many of the fish and other animals. including two families of <a class="gtmContentClick" data-vars-link-text="Asian small-clawed otters" data-vars-click-url="https://www.facebook.com/NCAquariumFF/posts/1332249242280196?ref=embed_post" data-vars-content-id="2a2d2d2e-f96d-4944-8fce-fdff17ba1be1" data-vars-headline="North Carolina Aquarium closing for yearslong expansion" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.facebook.com/NCAquariumFF/posts/1332249242280196?ref=embed_post" target="_blank">Asian small-clawed otters</a>, will remain on-site throughout construction, aquarium staff said.</li><li>Renovations will add a massive 400,000-gallon shark habitat, new touch tanks and more.</li></ul>Driving the news: Construction breaks ground Tuesday. The state says it will take around 30 months, putting completion in late 2028. <ul><li>North Carolina has <a class="gtmContentClick" data-vars-link-text="two other state-run aquariums" data-vars-click-url="https://www.ncaquariums.com/" data-vars-content-id="2a2d2d2e-f96d-4944-8fce-fdff17ba1be1" data-vars-headline="North Carolina Aquarium closing for yearslong expansion" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.ncaquariums.com/" target="_blank">two other state-run aquariums</a>, but Fort Fisher is the closest one to the Triangle.</li><li>Fort Fisher&#x27;s Civil War-era historic site and beach access both will remain open.</li></ul>By the numbers: The aquarium had about 474,000 visitors in 2025.If you go: Aquarium entry continues <a class="gtmContentClick" data-vars-link-text="9am-5pm" data-vars-click-url="https://www.ncaquariums.com/visit-fort-fisher" data-vars-content-id="2a2d2d2e-f96d-4944-8fce-fdff17ba1be1" data-vars-headline="North Carolina Aquarium closing for yearslong expansion" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.ncaquariums.com/visit-fort-fisher" target="_blank">9am-5pm</a> through Monday. Adult tickets cost $15.<ul><li>The drive from Wilmington takes about 30 minutes. </li><li>900 Loggerhead Road, Kure Beach</li></ul><figure><img alt="View of visitors, including many children, as they view various fish in a tank at the Fort Fisher Aquarium, Kure Beach, North Carolina, 1997. " height="3125" id="eb139a25-ff97-4611-841b-fc98a2b44e19" src="https://images.axios.com/dMbGQ11G1AI8i0MxbapijzwHlhA=/2026/05/21/1779385682123.jpeg" width="4800"/><figcaption>The Fort Fisher aquarium in 1997. Photo: Brownie Harris/Corbis via Getty Images</figcaption></figure>

ACA enrollment in North Carolina plummets after subsidies expire

The decline comes after enhanced subsidies for the plans expired.

Health

The number of North Carolinians enrolled in health insurance plans through the Affordable Care Act has fallen significantly this year. <ul><li>More than 200,000 fewer people are getting insurance via the program this year, <a class="gtmContentClick" data-vars-link-text="according to data compiled by KFF" data-vars-click-url="https://www.kff.org/affordable-care-act/state-indicator/marketplace-plan-selections-by-enrollment-type-2/?currentTimeframe=0&amp;selectedRows=%7B%22states%22:%7B%22north-carolina%22:%7B%7D%7D%7D&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D" data-vars-content-id="6e746ba5-e2a7-47be-abd4-253030351780" data-vars-headline="ACA enrollment in North Carolina plummets after subsidies expire" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.kff.org/affordable-care-act/state-indicator/marketplace-plan-selections-by-enrollment-type-2/?currentTimeframe=0&amp;selectedRows=%7B%22states%22:%7B%22north-carolina%22:%7B%7D%7D%7D&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D" target="_blank">according to data compiled by KFF</a>. </li></ul>Why it matters: The drop came after <a class="gtmContentClick" data-vars-link-text="enhanced subsidies" data-vars-click-url="https://www.axios.com/2025/12/18/obamacare-marketplace-upheaval-subsidy-extension" data-vars-content-id="6e746ba5-e2a7-47be-abd4-253030351780" data-vars-headline="ACA enrollment in North Carolina plummets after subsidies expire" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2025/12/18/obamacare-marketplace-upheaval-subsidy-extension" target="_self">enhanced subsidies</a> for the ACA expired, making plans more expensive for many people.

WakeMed's CEO makes his case for a merger with Atrium

WakeMed says its main campus needs at least $1 billion to be redeveloped.

WakeMed Health&#x27;s leadership said Tuesday that a merger with Atrium Health is needed to ensure the Wake County-based hospital network will be thriving a decade from now. Why it matters: Atrium&#x27;s potential takeover of WakeMed, which was founded by Wake County in 1961 and is a<a class="gtmContentClick" data-vars-link-text=" safety-net provider," data-vars-click-url="https://www.nyu.edu/about/news-publications/news/2023/september/safety-net-hospital.html" data-vars-content-id="7603ba51-0c04-418d-ac5c-c0e82ec37b27" data-vars-headline="WakeMed&#x27;s CEO makes his case for a merger with Atrium" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.nyu.edu/about/news-publications/news/2023/september/safety-net-hospital.html" target="_blank"> safety-net provider,</a> has been the talk of the town since it was <a class="gtmContentClick" data-vars-link-text="announced" data-vars-click-url="https://www.axios.com/local/raleigh/2026/05/01/wakemed-is-seeking-to-combine-with-atrium-health" data-vars-content-id="7603ba51-0c04-418d-ac5c-c0e82ec37b27" data-vars-headline="WakeMed&#x27;s CEO makes his case for a merger with Atrium" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2026/05/01/wakemed-is-seeking-to-combine-with-atrium-health" target="_self">announced</a> last Friday afternoon. <ul><li>State and local officials, however, have <a class="gtmContentClick" data-vars-link-text="raised strong opposition" data-vars-click-url="https://www.axios.com/local/raleigh/2026/05/04/atriums-acquisition-of-wakemed-receives-significant-pushback" data-vars-content-id="7603ba51-0c04-418d-ac5c-c0e82ec37b27" data-vars-headline="WakeMed&#x27;s CEO makes his case for a merger with Atrium" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2026/05/04/atriums-acquisition-of-wakemed-receives-significant-pushback" target="_self">raised strong opposition</a> to the speed and the scope of the deal. </li></ul>

Atrium's acquisition of WakeMed receives significant pushback

The merger would give Atrium, the state's largest hospital network, a foothold in the Triangle.

A vote on a <a class="gtmContentClick" data-vars-link-text="proposed merger" data-vars-click-url="https://www.axios.com/local/raleigh/2026/05/01/wakemed-is-seeking-to-combine-with-atrium-health" data-vars-content-id="dea2f66d-d10e-45c5-b2bc-62f7be2313b7" data-vars-headline="Atrium&#x27;s acquisition of WakeMed receives significant pushback" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2026/05/01/wakemed-is-seeking-to-combine-with-atrium-health" target="_self">proposed merger</a> between WakeMed Health and Atrium Health has been delayed after significant pushback from state and local officials. Why it matters: The potential merger would give Atrium Health, the state&#x27;s largest health care provider, a significant foothold in the Triangle.

WakeMed is seeking to combine with Atrium Health

WakeMed, previously owned by the Wake County until 1997, has three hospitals in Wake County

WakeMed Health, a nonprofit hospital that has served the Raleigh area since 1961, is moving to combine with Atrium Health, the state&#x27;s largest hospital system, they said in a joint release Friday. Why it matters: WakeMed is the third-largest healthcare provider in the Triangle, giving Atrium a large foothold here, if the combination is approved by regulators.<ul><li>Atrium, which has a significant presence in <a class="gtmContentClick" data-vars-link-text="Charlotte" data-vars-click-url="https://www.axios.com/local/charlotte/2026/04/29/south-charlotte-arts-hub-nonprofit-campus-plan-feasibility-study-funding-theater" data-vars-content-id="0814822d-8981-4ce6-b306-90cfb940f0af" data-vars-headline="WakeMed is seeking to combine with Atrium Health" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/charlotte/2026/04/29/south-charlotte-arts-hub-nonprofit-campus-plan-feasibility-study-funding-theater" target="_self">Charlotte</a> and the Triad, is part of the nonprofit healthcare company Advocate Health. </li></ul>

Duke study: AI model detects ADHD in kids as young as 5

Researchers say the tool could help clinicians identify ADHD sooner using large-scale health data.

Duke University researchers created an artificial intelligence model they say can accurately detect ADHD in 5-year-olds&#x27; health data.Why it matters: That&#x27;s years earlier than most kids are diagnosed, an example of how AI tools that analyze large datasets could <a class="gtmContentClick" data-vars-link-text="reshape health care" data-vars-click-url="https://www.axios.com/pro/health-tech-deals/2026/03/26/health-care-ai-tools-assessment" data-vars-content-id="01610a3d-7732-4821-85a9-bbdce1ddaf22" data-vars-headline="Duke study: AI model detects ADHD in kids as young as 5" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/pro/health-tech-deals/2026/03/26/health-care-ai-tools-assessment" target="_self">reshape health care</a> in the coming decades.

The questions you should be asking your primary care provider — and why they matter

Patients with a primary care provider they trust have better health care outcomes.

Partners

<div data-sponsor-disclosure="&quot;{&quot;logoUrl&quot;:&quot;https://images.axios.com/4CJecxx3TgEaWLyJ9p7cy8u4iS0=/2026/03/25/1774474220755.png&quot;,&quot;headline&quot;:&quot;A message from: Amazon One Medical&quot;}&quot;"></div><div style="display:none"></div>Nearly half of Americans feel anxious before a doctor&#x27;s appointment — and most leave at least one question they forgot or didn&#x27;t feel comfortable asking.Here&#x27;s the deal: The relationship between a patient and their primary care provider (PCP) is one of the strongest predictors of long-term health.Studies show that patients with a PCP they trust have better health outcomes, lower hospitalization rates and higher satisfaction with their care, but the structure of most primary care visits makes that relationship difficult to organically build.

Health care cost illusions still underpin debates

North Carolina's 2026 session could reshape health care affordability statewide.

North Carolinians are feeling the strain of rising healthcare costs — and as the 2026 short session approaches, how lawmakers address affordability could influence what families pay, how employers structure coverage and how providers are reimbursed.Why it&#x27;s important: Health care affordability is shaped by a complex mix of insurance design, pharmaceutical pricing, regulatory decisions, provider costs and patient needs, all interacting within the broader health care landscape.<ul><li>For policymakers, that means reform requires examining how decisions in one part of the ecosystem affect the rest — not just the most visible components of care delivery.</li></ul>

Health care providers urge checking measles vaccine status as cases surge

Two shots of the MMR give widespread protection against measles.

North Carolina has confirmed <a class="gtmContentClick" data-vars-link-text="22 cases " data-vars-click-url="https://www.dph.ncdhhs.gov/programs/epidemiology/communicable-disease/infectious-respiratory-diseases/measles-rubeola/measles-cases-and-outbreaks-north-carolina" data-vars-content-id="739579fd-1d01-4ef4-9ca7-59c2eb77529d" data-vars-headline="Health care providers urge checking measles vaccine status as cases surge" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.dph.ncdhhs.gov/programs/epidemiology/communicable-disease/infectious-respiratory-diseases/measles-rubeola/measles-cases-and-outbreaks-north-carolina" target="_blank">22 cases </a>of measles in the state since December amid a <a class="gtmContentClick" data-vars-link-text="national resurgence in cases" data-vars-click-url="https://www.axios.com/2025/12/30/us-texas-measles-cases-cdc-vaccine-rfk-jr" data-vars-content-id="739579fd-1d01-4ef4-9ca7-59c2eb77529d" data-vars-headline="Health care providers urge checking measles vaccine status as cases surge" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2025/12/30/us-texas-measles-cases-cdc-vaccine-rfk-jr" target="_self">national resurgence in cases</a> and a hot spot in neighboring South Carolina. Why it matters: Health care providers are <a class="gtmContentClick" data-vars-link-text="urging" data-vars-click-url="https://www.dukehealth.org/blog/measles-exposure-and-vaccination-what-you-need-know" data-vars-content-id="739579fd-1d01-4ef4-9ca7-59c2eb77529d" data-vars-headline="Health care providers urge checking measles vaccine status as cases surge" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.dukehealth.org/blog/measles-exposure-and-vaccination-what-you-need-know" target="_blank">urging</a> people to check their vaccine status and see if they received one dose, two doses or no doses of the measles, mumps and rubella vaccine as a child.

Demand for GLP-1s from North Carolina Medicaid patients has grown significantly

GLP-1s remain expensive, causing many state Medicaid programs not to cover it

North Carolina is one of 13 states whose Medicaid programs cover <a class="gtmContentClick" data-vars-link-text="GLP-1s" data-vars-click-url="https://www.axios.com/local/raleigh/2026/01/12/wegovy-weight-loss-the-triangle-north-carolina" data-vars-content-id="f275b217-8fa3-481b-8b36-2414867968c7" data-vars-headline="Demand for GLP-1s from North Carolina Medicaid patients has grown significantly" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2026/01/12/wegovy-weight-loss-the-triangle-north-carolina" target="_self">GLP-1s</a> for weight loss treatment, and their usage in the state has skyrocketed in recent years. Why it matters: The number of Medicaid claims for GLP-1s as a prescription for weight loss surged from practically zero in 2023 to more than 211,000 in the past year, according to data from the N.C. Department of Health and Human Services. <ul><li>Medicaid coverage of GLP-1s for weight management began in August 2024. The drugs treat other conditions, including diabetes. Medicaid processed an additional 257,320 GLP-1 claims related to other conditions in North Carolina last year.</li></ul>

World's first weight loss pill is made in the Triangle

Many of the most popular weight loss drugs are being made in North Carolina.

North Carolina has quickly become a leading hub for the manufacturing of GLP-1 weight loss drugs, including the new <a class="gtmContentClick" data-vars-link-text="Wegovy pill" data-vars-click-url="https://www.axios.com/2025/12/22/fda-weight-loss-pill-glp-1-approved" data-vars-content-id="de863d0e-ecd4-4a4a-8806-c7346259da9a" data-vars-headline="World&#x27;s first weight loss pill is made in the Triangle" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2025/12/22/fda-weight-loss-pill-glp-1-approved" target="_self">Wegovy pill</a> that&#x27;s now on the market.Why it matters: Having a pill form as opposed to a weekly shot is a big deal, largely because pills are cheaper to make than the widely popular injectables, NPR recently <a class="gtmContentClick" data-vars-link-text="reported" data-vars-click-url="https://www.npr.org/2025/11/25/nx-s1-5619816/obesity-pills-wegovy-semaglutide-orforglipron" data-vars-content-id="de863d0e-ecd4-4a4a-8806-c7346259da9a" data-vars-headline="World&#x27;s first weight loss pill is made in the Triangle" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.npr.org/2025/11/25/nx-s1-5619816/obesity-pills-wegovy-semaglutide-orforglipron" target="_blank">reported</a>.

A line chart that shows North Carolina Affordable Care Act enrollment annually from 2019 to 2026. Enrollment rose from 501,271 in 2019 to a peak of 1,027,930 in 2024, then fell to 975,110 in 2025 and 761,457 in 2026. The trend climbs steadily through 2024, then reverses.

Affordable Care Act enrollment in North Carolina

Data: KFF; Note: Enhanced ACA subsidies began in 2021 and ended in 2025.; Chart: Zachery Eanes/Axios

Health 🩺

ACA enrollment in North Carolina plummets after subsidies expire

WakeMed's CEO makes his case for a merger with Atrium

Atrium's acquisition of WakeMed receives significant pushback

WakeMed is seeking to combine with Atrium Health

Duke study: AI model detects ADHD in kids as young as 5