What new laws in 2026 mean for North Carolina — and why they matter

As 2026 approaches, North Carolina residents will see dozens of new laws take effect, reflecting a legislative session marked by policy expansion, regulatory tightening, and unresolved political tension over the state budget. While lawmakers enacted wide-ranging statutory changes, the failure to pass a comprehensive budget has left teacher and state employee pay raises uncertain, underscoring a split between policy action and fiscal agreement.

The changes stem from legislation ratified during the 2025 session of the North Carolina General Assembly, with nonpartisan summaries published by the Legislative Analysis Division.

Health care: Access, transparency and safety

Several 2026 laws focus on health care access and oversight. Senate Bill 479, known as the SCRIPT Act, increases regulation of pharmacy benefit managers, aiming to curb practices that lawmakers say disadvantage independent pharmacies and limit patient choice. Other statutes streamline licensing for internationally trained physicians, a move intended to address provider shortages, particularly in rural areas.

Patient and worker safety is also addressed through new requirements for filtering surgical smoke in operating rooms, aligning North Carolina with standards increasingly adopted nationwide. Collectively, these measures reflect bipartisan concern over access, competition and safety within the health care system.

Transportation and local authority

Under House Bill 926, local governments will no longer be allowed to impose road design standards that exceed those set by the North Carolina Department of Transportation. Supporters argue the change promotes uniformity and predictability for developers and contractors, while critics warn it limits local flexibility in addressing community-specific traffic and safety concerns.

Business, finance and legal modernization

A series of laws modernizes how business and legal matters are handled in North Carolina. Control of certain state investments shifts to the newly created North Carolina Investment Authority, a move designed to centralize and professionalize oversight.

Other changes include updated licensing rules for certified public accountants, simplified access to original birth certificates for adopted individuals, and authorization for attorneys to store certified electronic copies of wills beginning Jan. 1, 2026. Lawmakers described these steps as overdue updates that reflect technological and administrative realities.

The unresolved budget backdrop

Despite the volume of enacted laws, the absence of a finalized state budget remains a defining feature of the session. Without a budget, proposed raises for teachers and state employees remain in limbo. The contrast highlights a legislature capable of advancing targeted policy reforms while struggling to reach consensus on broader fiscal priorities.

Incremental reform amid structural gridlock

A review of the Legislative Analysis Division’s summaries shows a clear pattern: lawmakers prioritized incremental, issue-specific reforms over sweeping structural changes. Health care regulation, professional licensing, and administrative modernization dominate the list of 2026 effective dates, suggesting an emphasis on efficiency and oversight rather than expansion of services.

At the same time, the unresolved budget exposes deeper political divides. While policy bills can move through committees and floor votes individually, comprehensive budget negotiations require broader compromise.

As 2026 begins, North Carolinians will experience tangible changes in health care access, legal processes, and local governance. Whether those changes are overshadowed by continued budget stalemates remains an open question for the year ahead.