North Carolina's Healthy Opportunities Pilot will return in early 2027, offering only grocery deliveries
The Medicaid pilot, paused since July 2025, restarts with one of its 29 services and a $25 million budget. Community organizations will no longer be paid to find and refer participants, and no exact start date has been set.
Raleigh. North Carolina's Healthy Opportunities Pilot, which used Medicaid money for food, housing and other non-medical help in three largely rural regions, will resume in early 2027 in a much smaller form that offers only grocery deliveries, North Carolina Health News reported on Nov. 4.
The pilot stopped in July 2025 after the General Assembly did not fund it, according to the N.C. Department of Health and Human Services. The department says lawmakers have since approved $9 million in state funding for the 2027 state fiscal year to restart services, and that, together with federal matching funds, it is working out how to serve a subset of Medicaid members who meet specific eligibility requirements.
An earlier report said the program would return in January. The department has since told North Carolina Health News that it will return in early 2027 and that an exact date has not been set.
One service, for fewer people
Before the pause, the pilot paid for 29 services, from home repairs to help with rent and family therapy. When it returns, it will deliver boxes of groceries to people who are food insecure and either pregnant or diagnosed with diabetes or cardiovascular disease, the newspaper reported. Each box will be meant to feed about two people two meals a day for a week; deliveries used to be sized to the household.
The state budget set aside $25 million in one-time money for the restart, the newspaper reported. WLOS reported in July that the sum combines $9 million in state funds with $16 million in federal Medicaid funds. Laurie Stradley, chief executive of Impact Health, which runs the pilot in 18 western counties, said the money is "about a 10th of what it would take for us to operate at full steam." She estimated that Impact Health would serve 3,500 to 5,000 people in the first six months, down from nearly 14,000 when the pilot was suspended.
What changes for community organizations
Under the original pilot, community organizations and care management providers were paid to identify people who needed help, determine their eligibility and coordinate referrals. That money will not be available when the program resumes, according to North Carolina Health News. Medicaid managed care plans will take over care management and referrals, and the startup funds that helped local organizations cover costs while they waited to be reimbursed will not return.
Ms. Stradley said she expects fewer organizations to be able to provide food deliveries.
The pilot's other two regions are run by Access East, in the northeast, and Community Care of the Lower Cape Fear, in the southeast. The department says it will contact its partners directly as details are finalized.
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