Opinion: We proved bipartisan health care reform works in North Carolina. Let’s bring it nationwide — SkimNews
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- North Carolina's Healthy Opportunities Pilots used Medicaid dollars to pay for healthy food, housing, and transportation for enrollees, with a multiyear evaluation by the UNC Sheps Center for Health Services Research covering 31,000+ participants from 2022 through late 2024.
- The program saved Medicaid an average of $164 per person per month after accounting for service and overhead costs, with savings building over time and reaching statistical significance by the final measurement period.
- Participants had significantly fewer emergency department visits and hospital admissions and more outpatient provider contact, while reporting reductions in food insecurity, housing instability, and transportation barriers.
- Nearly 90% of participants said HOP improved their own health and their children's health, according to the authors.
- North Carolina's legislators voted in July to continue the program after it was paused during the state's budget impasse, scaling access to the program's key cost-saving drivers.
- Former Gov. Roy Cooper's administration built the pilot in 2018 with the first Trump administration and North Carolina's Republican-led legislature, which the authors cite as proof bipartisan health care reform is achievable.
- The authors, former NC HHS secretaries Mandy Cohen and Kody Kinsley, are urging Congress to codify pathways for states to integrate evidence-based social services into Medicaid and for CMS to expand waiver authority.
Why it matters: At scale, $164 per member per month represents billions in potential savings for state and federal Medicaid budgets while addressing social drivers of health, giving fiscal conservatives and public-health advocates a shared policy blueprint — and putting pressure on Congress to act without forcing each state to seek its own waiver.
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