A Year After Helene, a Vital Safety Net Vanishes
One year after Hurricane Helene devastated western North Carolina, a pioneering Medicaid program that helped thousands access food, housing, and transportation has been abruptly discontinued—leaving the state’s most vulnerable residents in limbo.
The Program That Worked—Until It Didn’t
Launched as a temporary emergency measure in late 2024, North Carolina’s Medicaid Community Supports Pilot allowed enrollees to receive non-medical aid critical to recovery: groceries, temporary housing, utility assistance, and rides to clinics. Funded through a federal Section 1115 waiver, it served over 12,000 residents across 23 counties hit hardest by Helene.
“It kept me from becoming homeless,” said Maria Lopez, 68, of Haywood County, who used the program to pay for a month’s rent after floodwaters destroyed her mobile home. “Now I don’t know what I’ll do.”
Why Was It Cut?
State officials cited budget constraints and the expiration of federal emergency flexibilities. Despite bipartisan praise and evidence of reduced hospitalizations and ER visits among participants, the Department of Health and Human Services (NCDHHS) declined to renew the waiver in August 2025.
Who’s Affected?
- Elderly residents with chronic illnesses
- Disabled adults reliant on consistent care access
- Low-income families still repairing storm damage
- Rural patients with no public transportation
Impact by the Numbers
| Metric | During Program (Oct 2024–Aug 2025) | Post-Cut (Sep–Dec 2025, projected) |
|---|---|---|
| People Receiving Housing Aid | 3,200+ | 0 |
| Monthly Food Assistance Recipients | 8,500 | 0 |
| ER Visits (Western NC, monthly avg.) | 1,120 | 1,450+ (est.) |
| Missed Medical Appointments | ↓ 34% | ↑ Expected 50% |
Expert Insight: “Cutting housing and food support isn’t just cruel—it’s expensive,” said Dr. Lena Patel, health policy researcher at UNC-Chapel Hill. “Every $1 spent on these services saves $3 in avoidable hospital care.”
Broader Implications
North Carolina’s retreat comes as other states—like Oregon, California, and New York—are expanding Medicaid-funded social services under new federal guidelines. Advocates warn the decision could deepen health inequities in a region already short on providers.
For more on Medicaid policy shifts, see [INTERNAL_LINK:medicaid-social-services].
