North Carolina is bringing back one of its most closely watched Medicaid programs, but the relaunch will look different from the version that operated before funding was suspended.

The state plans to relaunch the Healthy Opportunities Pilot in early 2027 with about $25 million in state and federal funding.

The General Assembly provided $9 million in the state budget, which NCDHHS says will unlock federal matching funds and bring the total investment to approximately $25 million.

The biggest change: the program will focus only on food insecurity.

The earlier version tested Medicaid-funded services tied to food, housing, transportation and interpersonal safety.

The streamlined relaunch will instead provide weekly healthy food boxes to qualifying NC Medicaid members with the greatest needs.

Who may qualify

Members will need to live in one of the existing Healthy Opportunities regions, experience food insecurity and meet qualifying health criteria.

NCDHHS says the initial relaunch will focus on people who are pregnant or who have diabetes and/or cardiovascular disease.

Care managers will assess members for eligibility and connect those who qualify to services.

Charlotte and Mecklenburg County are not in the current pilot area.

The three regions remain unchanged and cover 33 counties in western and eastern North Carolina through Impact Health, Access East and Community Care of the Lower Cape Fear.

That distinction matters for organizations and residents in the Charlotte area because the announced relaunch is not a statewide benefit.

Why the state is bringing it back

A UNC evaluation found that participants had fewer emergency department visits and hospital stays than expected without the program, while using more lower-cost outpatient care.

NCDHHS also says food services made up the majority of the interventions delivered during the first two years of the original pilot.

The department is using that evidence to concentrate limited funding on nutrition support first.

What this means for nonprofits and community organizations

Human Services Organizations will continue to play a central role by delivering authorized food services directly to eligible members.

Network Leads will manage provider networks in each pilot region, while Medicaid health plans will authorize and pay for services.

For organizations already working in food access, nutrition or community health in the 33 pilot counties, the relaunch is worth watching closely for contracting and referral opportunities.

What happens next

The program is expected to restart in early 2027 and run under the food-focused model through June 30, 2027.

NCDHHS says the official launch date will be shared with participating organizations and other stakeholders at least 30 days before services begin.

The department also says additional services could be considered later if more funding becomes available.

Read the NCDHHS relaunch announcement for the latest funding and eligibility details.

See the Healthy Opportunities Pilot overview for the current regions, participating organizations and program background.

Use these official sources to understand the relaunch, participating regions and how the program will work in 2027.

NCDHHS Relaunch Announcement

Read the state's Nov. 9 announcement for the funding level, eligibility focus and expected relaunch timing.

Healthy Opportunities Pilot Overview

See the current pilot regions, participating organizations and program background.