Bipartisan Medicaid pilot in North Carolina cuts costs and improves health
A Medicaid experiment in North Carolina that funds food, housing and transport saved about $164 per enrollee each month and reduced emergency visits.
In North Carolina, a bipartisan effort created the Healthy Opportunities Pilots to channel Medicaid funds into nutrition, housing and transportation assistance for low-income residents. Built with input from the governor, a Republican-controlled legislature and local nonprofits, the program was evaluated by the University of North Carolina Sheps Center, covering over 31,000 enrollees from 2022 through late 2024. Results indicated a monthly net saving of $164 per participant, driven by reduced emergency-department visits and hospital stays, alongside measurable improvements in food security, housing stability and access to outpatient care.
Nearly nine-in-ten participants said the program benefited their health and that of their children. The state legislature voted in July to continue and expand the pilot after a budget pause, and policymakers are calling on CMS to broaden waiver authority so other states can replicate the model.
Why it matters
The program shows how Medicaid-funded social services can lower costs and improve health, offering a model for nationwide policy.
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