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2025-2026 Legislative and Public Policy Priorities

North Carolina's General Assembly is currently in session. NCPA staff and lobbyists are monitoring bills and have been on hand for legislative discussions of great significance to psychiatry. NCPA is available to serve as a resource to policy leaders in the state. We are focused on the following issues of importance to mental health...

  • Enforce Mental Health Parity in North Carolina

  • Ensuring Adequate and Qualified Workforce

  • Promoting Quality Behavioral Health Care Access

  • Decriminalizing Mental Illness and Substance Use Disorders

For more information regarding NCPA's legislative priorities, email [email protected] 
Where Can I See What APA is Doing?
Visit APA’s Advocacy Action Center at psychiatry.org/advocacy for the latest information on APA’s
advocacy activities. The members-only Advocacy Action Center has an up-to-date list of recent actions taken by APA.

North Carolina Primary Election Report

U.S. Senate, U.S. House, and North Carolina General Assembly
North Carolina held one of the nation’s earliest primary elections of the 2026 cycle, coinciding with contests in Texas and Arkansas. The results set the stage for several nationally significant races that will influence control of Congress and shape federal and state policy during the second half of President Donald Trump’s second term.

U.S. Senate
North Carolina’s open U.S. Senate seat immediately emerged as one of the most competitive and expensive races in the country. National organizations in both parties have already signaled that the state will be a top-tier battleground.

Primary Results

  • Republican Nominee: Former Republican National Committee Chairman Michael Whatley, endorsed by President Trump, won the GOP primary with 64.6% of the vote.
  • Democratic Nominee: Former Governor Roy Cooper secured the Democratic nomination with 92% support.
Outlook

Early spending projections indicate that total investment in the race could reach $600 million to $1 billion, placing it among the most expensive Senate contests in U.S. history. The seat is widely viewed as pivotal to determining the balance of power in the U.S. Senate.

U.S. House of Representatives

Redistricting and Key Races
In October 2025, the North Carolina General Assembly enacted a new congressional map for the 2026 cycle. The most consequential change occurred in District 1, represented by Congressman Don Davis, which was redrawn to favor Republican candidates.

  • District 1:
  • Republican Nominee: Laurie Buckhout
  • Democratic Nominee: Congressman Don Davis
    This race is expected to be one of the most competitive in the state, with Davis now considered one of the most vulnerable Democratic incumbents due to the district’s new partisan composition.

District 4 Democratic Primary
One of the state’s most closely watched primaries unfolded in District 4, where incumbent Representative Valerie Foushee faced a strong challenge from Nida Allam.

  • Allam received support from U.S. Senator Bernie Sanders and several progressive, anti-establishment organizations, framing the contest as an ideological battle within the Democratic Party.
  • Preliminary results show:
    • Foushee: ~49.18%
    • Allam: ~48.22%
    • The margin—approximately one percentage point—has prompted discussion of a potential recount, which will depend on final canvassing and certification.

North Carolina General Assembly

Statewide Turnout and Incumbent Losses
Legislative primaries were highly competitive, with 1,505,264 voters participating statewide, representing 19.64% turnout among the state’s 7.66 million registered voters.

A total of nine incumbents lost their primaries:

  • Democrats: Shelly Willingham, Rodney Pierce, Nasif Majeed, Carla Cunningham Republicans: Reece Pyrtle, Keith Kidwell, Kelly Hastings, Mark Pless, Chris Measmer

These results highlight growing intraparty tensions in both parties, with voters increasingly willing to challenge their own party’s establishment.

Senate District 26: Berger vs. Page
The most closely watched legislative race of the cycle occurred in Senate District 26, where Senate President Pro Tempore Phil Berger faced a challenge from Rockingham County Sheriff Sam Page.

Current Status

  • Preliminary results show Sheriff Page with a two-vote lead, making this one of the closest legislative races in recent state history.
  • Sheriff Page has declared an early victory.
  • Senator Berger has stated he will wait for all remaining information to be verified before making any final decision.

Context and Significance
Senator Berger, who has served since 2011, is one of the most influential figures in North Carolina politics and has shaped major legislative initiatives for more than a decade. His leadership role elevated the stakes of this primary, which drew national attention and prompted nearly $10 million in outside spending on his behalf—an estimated 15-to-1 advantage over the support directed to Sheriff Page.
Sheriff Page positioned himself as an anti-establishment challenger, backed primarily by grassroots conservative organizations and activists who sought to channel voter frustration toward longstanding legislative leadership.

Next Steps
Given the extremely narrow margin, a recount is widely expected. Under North Carolina law, a recount request must be filed by noon on Tuesday, March 17. The final outcome will depend on canvassing, certification, and any recount proceedings.

Weekly Legislative Updates 

Coming Soon! The short session begins April 21, 2026.
 

NCPA's Advocacy Efforts

The NC Psychiatric Association is a non-partisan organization that works to represent and advance the practice of medicine and psychiatry in North Carolina through the policy-making and legislative process. But what does that actually mean, and how do we advocate for our members and the mental health field?

  • We have registered lobbyists who works hard to make sure psychiatrists, providers, and mental health professionals are at the table during important policy-making discussions and meetings. 
  • We attend legislative meetings and talk to legislators and other policymakers to ensure they have the facts about how legislative decisions will affect patients, providers, and others. 
  • We track legislation that affects the mental health field, including issues related to substance use disorders, and the practice of psychiatry. 
  • We are part of statewide coalitions, committees, and work groups that discuss mental health and substance use disorders to monitor issues, trends, and policies. 
  • We sponsor and participate in advocacy events at the General Assembly. Our members also participate in White Coat Wednesday events, where physicians attend the General Assembly to raise awareness of medical issues and the practice of medicine in North Carolina. 
  • We issue position statements and communicate with legislators, the Governor, and other government officials about the benefits and potential consequences of specific legislation and policies. 

We encourage our members and the public to stay informed and involved, and we hope the resources found here will help you do that.
 

NCPA's Advocacy Events

Each year, NCPA holds Legislative Advocacy Days where members travel to Raleigh to meet with legislators at the NC General Assembly. These advocacy days allow members to experience the legislative process first-hand, meet directly with their district's legislators, and educate government officials about policy issues. 

Many times, NCPA Advocacy Days will coincide with the NC Medical Society's White Coat Wednesdays. Members attend a policy education and training session and learn how to best approach legislators about important health care issues. These days are fast-paced and make an impact.

If you are interested in learning about or participating in an Advocacy Day, contact us!