North Carolina Shutters Medicaid HRSN Pilots Despite Savings

On July 1, 2025, the North Carolina Department of Health and Human Services (NCDHHS) ended the Healthy Opportunities Pilots (HOP), which was enabled by the use of Medicaid funds to pay for non-medical health related social needs (HRSNs). As late as March 2025, NCDHHS had been planning to expand the program statewide. The state’s General Assembly did not include funding for state fiscal years 2026 and 2027.

HOP operated under an 1115 Medicaid demonstration waiver, which was originally approved in October, 2018. HOP built its presence across three regions of the state, spanning 33 counties. In October 2023 . . .