One year after Hurricane Helene, many families in western North Carolina can no longer rely on a program that once helped them get food, housing, and medical support.
Krista Shalda, a single mother of two boys with serious medical needs, often shared photos with friends of her fridge full of fresh fruits, vegetables, and dairy, all provided by the Healthy Opportunities Pilot (HOP) program.
Five years ago, North Carolina started the HOP program to test whether giving Medicaid recipients nutritious food, safe housing, and transportation to doctor visits could improve health and reduce expensive hospital visits.
For Krista, that meant receiving weekly boxes of fresh produce that helped her 15-year-old son follow a strict diet, reducing his trips to the emergency room.
Kellie Prince, who became homeless while recovering from spinal surgery, got a motel room for several weeks so her family wouldn’t have to sleep in a car.
Debra Hensley, 60, who is partially blind and physically disabled, received a new roof and electrical repairs for her aging trailer. “It’s not an exaggeration to say that HOP saved my life,” she said.
North Carolina Medicaid Cuts Threaten Vulnerable Families
The program cost $650 million but showed strong results. A UNC School of Medicine analysis found that HOP saved $1,000 per participant each year for the 13,000 Medicaid recipients in the program.
However, the program is now shutting down due to cuts in Medicaid funding approved by Congress in July. State Republican leaders said reductions in federal health care funding left them no choice. Many participating organizations have already stopped providing services.
“There’s a lot of heartache and disappointment to watch the demise of something that helped the community,” said Laurie Stradley, CEO of Impact Health, a nonprofit that helped run HOP.
The cuts are part of a $320 million reduction in North Carolina Medicaid spending, affecting the state’s three million recipients. Asheville and surrounding counties, still recovering from Hurricane Helene, are especially hard hit.
Local Economy and Farmers Impacted by HOP Ending
While wealthy retirees and digital nomads have moved into the area, low-wage workers struggle with rising housing costs and a $7.25 minimum wage.
Some state leaders have questioned the program’s effectiveness. House Speaker Destin Hall said in June, “It’s not clear from our side that any folks are really benefiting from that program anyway.”
Experts argue otherwise. Seth A. Berkowitz, a doctor evaluating the program, said HOP helped families in crisis regain stability. “You help a family through a rough patch, and it translates into better health and lower costs later,” he said.
Local farmers also benefited. Nicole DelCogliano, who grows organic vegetables in Yancey County, said HOP helped her recover from $250,000 in damages from Helene.
Much of her produce went to community markets run by Bounty & Soul, serving 26,000 people each month. But with the program’s end, 260 Medicaid recipients no longer receive weekly boxes of fresh food.
Families Struggle Without Weekly Food Boxes
For Krista Shalda, this has been especially difficult. Her oldest son, Alex, 15, has hydrocephalus and a history of seizures and kidney stones.
The HOP food boxes made following his complex diet possible. Since the program ended in July, the family has relied more on frozen and canned vegetables. “The frozen carrots taste like mush,” Alex said. His mother worries his health will decline further as federal cuts take effect.
Kellie Prince, caring for three grandchildren, also struggles. She lost food stamps and federal disability payments when her husband’s new job increased the family income slightly.
After surviving homelessness, surgeries, and a recent double mastectomy for breast cancer, she now faces the stress of feeding her family with limited resources.
“It’s hard to recover properly when you’re worried about feeding your family,” she said. She was recently hospitalized after small strokes left her unable to speak and with numbness on her right side.
The HOP program showed that providing support for basic needs can improve health, protect families, and strengthen communities. Its loss highlights the harsh consequences of Medicaid cuts for vulnerable Americans.
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The writer is a real estate journalist specializing in all types of New York City properties, including luxury residences, commercial spaces, and homes.
He also writes humorous articles about real estate, investors, and realtors.
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