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Opinion: NC’s HOP program has led to healthier residents, lower medical costs. It needs funding

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Opinion: NC’s HOP program has led to healthier residents, lower medical costs. It needs funding


The best way to lower health care costs is to reduce the need for expensive medical services by preventing illness in the first place. Thanks to the foresight of North Carolina lawmakers, our state tested a pilot program that does just that. In only two years, people are healthier and health care costs are lower. But despite its success, the future of the Healthy Opportunities Pilot is unclear.

As the two most recent secretaries of the North Carolina Department of Health and Human Services, we launched HOP by working with the Republican-led General Assembly and with the first Trump administration, which approved the pilot. North Carolina’s innovation has since become a model for other states and earned national attention for its impact.

HOP is based on a simple idea — it costs less to keep people healthy than to treat them after they get sick. We spend most of our money in this country treating diseases, rather than preventing them. Evidence from HOP has shown that investing in things that impact your health such as food and housing not only prevents disease but also saves money.

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Recent studies show HOP reduces health care costs by $1,020 per participant each year. The savings come from people needing fewer trips to the emergency room and fewer hospital admissions. People are staying healthy because local farmers, nonprofits, and small businesses deliver meals so people have healthy food, make home repairs that get rid of mold and help avoid asthma attacks, and help patients get preventive care and medicine when they need it, not after it becomes an emergency.

In Western North Carolina, families displaced by Tropical Storm Helene faced similar challenges. One mother, whose child suffered from asthma, received support from HOP to make their new home safer by removing mold and other triggers through the Breathe Right program. The result? Fewer ER visits and a healthier future. In the Cape Fear region, a young single mother was struggling with unsafe housing, food insecurity, and her children’s health problems. With support from HOP — including help with housing, food access, and parenting resources — she found stability. She secured full-time work, moved her family into a safe home, and saw their health improve dramatically.

And yet, despite these successes, North Carolina lawmakers have not included specific funding for HOP in either the House or Senate budget proposals. Without funding, millions in federal dollars will be pulled out of our rural communities, emergency department and hospital visits will likely rise again, health care costs will increase, and people’s health will be at risk.

Cutting programs like HOP does not save money. It just shifts costs to emergency rooms, schools, and long-term care facilities — and drives up costs for all of us. It’s why lawmakers funded Healthy Opportunities in the first place. And now that it’s delivered on the promise of saving costs, it’s time to double down on what works. In December of last year, noting the proven success of HOP, the federal government approved expanding the pilots statewide, which could unlock amazing opportunities across all of North Carolina. As North Carolina faces tough budget choices, sustaining and growing programs like HOP is the fiscally responsible decision. It supports healthier families, stronger communities, and a more sustainable health care system.

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With uncertainty at the federal level and no funding included for HOP in either the North Carolina House or Senate budgets, the program’s future hangs in the balance. If it ends, the consequences will be real — lives, jobs, and hurricane recovery efforts will all be at risk. In a time when so much feels uncertain, this is a solution we can agree on. The evidence is clear, the need is urgent, and the stakes are high. Our state must continue to lead the way with common-sense improvements to our health system.

The question is not how we can afford to do this; it is how we cannot?

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Dr. Mandy Cohen and Kody Kinsley are former Secretaries, NC Department of Health and Human Services.



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Statewide tornado drill has NC schools and workplaces practicing safety

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Statewide tornado drill has NC schools and workplaces practicing safety


Wednesday, March 4, 2026 6:41PM

NC schools and businesses encouraged to practice tornado safety

RALEIGH, N.C. (WTVD) — North Carolina schools and businesses took part in a statewide tornado drill Wednesday morning as part of Severe Weather Awareness Week.

The National Weather Service led the drill at 9:30 a.m., broadcasting it on NOAA Weather Radio and the Emergency Alert System. Schools, workplaces and households across the state were encouraged to join in.

The National Weather Service didn’t issue a follow up alert to mark the end of the drill. Instead, each school or business wrapped up once they felt they had practiced the procedures thoroughly.

Wednesday’s drill also replaced the regular weekly NOAA Weather Radio test.

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SEE | New warning for parents amid new ‘fire-breathing’ social media trend

Make sure to download the ABC 11 Mobile App ABC11 North Carolina Apps for Connected TV, Mobile News, Echo

Copyright © 2026 WTVD-TV. All Rights Reserved.



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North Carolina Rep. Valerie Foushee holds narrow lead over challenger Nida Allam

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North Carolina Rep. Valerie Foushee holds narrow lead over challenger Nida Allam


Nida Allam in 2022; Rep. Valerie Foushee (D-NC) in 2025.

Jonathan Drake/Reuters; Andrew Harnik/Getty Images


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Jonathan Drake/Reuters; Andrew Harnik/Getty Images

Incumbent Rep. Valerie Foushee holds a narrow lead over challenger Nida Allam in the Democratic primary for North Carolina’s 4th Congressional district as ballots continue to be counted.

In a race seen as an early test of whether Democratic voters desire generational change within the party, Foushee holds a lead of just over 1,000 votes with 99% of results in so far, according to the Associated Press.

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Under state law, provisional votes will be counted in the coming days in a district that includes Durham and Chapel Hill. If the election results end up within a 1% margin, Allam could request a recount.

Successfully ousting an incumbent lawmaker is often extremely difficult and rare. However, there have been recent upsets in races as some voters are calling for new leaders and several sitting members of Congress face primary challengers this cycle.

Allam, a 32-year-old Durham County Commissioner, is running to the left of Foushee, 69, framing her candidacy as part of a broader rejection of longtime Democratic norms.

On the campaign trail, Allam ran on an anti-establishment message, pledging to be a stronger fighter than Foushee in Congress, both in standing up against President Trump’s agenda and when pushing for more ambitious policy.

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“North Carolina is a purple state that often gets labeled red, but we’re not a red state,” she told NPR in an interview last month, emphasizing the need to address affordability concerns. “We are a state of working-class folks who just want their elected officials to champion the issues that are impacting them.”

She drew a contrast with the congresswoman on immigration, voicing support for abolishing U.S. Immigration and Customs Enforcement. Foushee has declined to go that far, advocating instead for ICE to be defunded and for broader reforms to the federal immigration system.

Allam also clashed with Foushee over U.S. policy towards Israel. As a vocal opponent of Israel’s war in Gaza, Allam swore off campaign donations from pro-Israel lobbying groups, such as AIPAC, and repeatedly criticized Foushee for previously accepting such funds.

Though Foushee announced last year that she would not accept AIPAC donations this cycle, she and Allam continued to spar over the broader role of outside spending in the race.

Their matchup comes four years after the candidates first squared off in 2022, when Allam lost to Foushee in what became the most expensive primary in the state’s history, with outside groups spending more than $3.8 million.

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However, this year is poised to break that record. Outside groups have reported spending more than $4.4 million on the primary matchup, according to Federal Election Commission filings.

WUNC’s Colin Campbell contributed to this report.



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Building for tomorrow’s storms: North Carolina updates flood strategy

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Building for tomorrow’s storms: North Carolina updates flood strategy


North Carolina is beginning to plan for floods that have not happened yet.

State officials this year advanced the next phase of the state’s Flood Resiliency Blueprint, incorporating updated modeling that factors in heavier rainfall, future development and sea-level rise — a shift away from relying solely on historic data and FEMA’s regulatory maps.

“We can make decisions and plan for that future, not just the exposure to flooding that we see now,” said Stuart Brown, who manages the Flood Resiliency Blueprint for the North Carolina Department of Environmental Quality.

For a state that has endured record-breaking rainfall from Hurricane Helene in the mountains to Tropical Storm Chantal in the Triangle, the move reflects a growing recognition: past standards no longer capture present risk.

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Beyond outdated flood lines

Multiple North Carolina studies have found that between 43% and 60% of flood damage occurs outside FEMA’s regulatory flood zones. Those maps shape insurance requirements and local zoning decisions, yet they are largely based on historical rainfall data.

“A lot of the regulatory floodplains really haven’t kept up with what we know is happening,” said Elizabeth Losos, executive in residence at Duke University’s Nicholas Institute for Energy, Environment and Sustainability.

Climate data show rainfall intensity in the Triangle has increased by about 21% since 1970. Warmer air holds more moisture, fueling heavier downpours that overwhelm drainage systems designed for a different climate.

“Fixing what we know is flooding right now is good,” Losos said. “It’s better than nothing, but it’s definitely not enough.”

Brown said the blueprint incorporates projections for future precipitation and development — a critical factor in one of the fastest-growing states in the country.

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“Development can be an issue for flooding in two categories,” Brown said. “One is when that development is occurring in areas that are flood prone. The other is when that development is done in ways that don’t account for the additional stormwater that will be produced.”

Thousands of projects, limited dollars

Unlike states that rely on massive levee systems, North Carolina’s flood risk is scattered across river basins, coastal plains and rapidly developing suburbs. Brown said resilience here will require thousands of localized projects.

“We were asked by the General Assembly to provide specific, actionable projects,” Brown said. “We want to know what specific geography and what specific action is proposed.”

That planning push comes as federal support for flood research and mitigation is shrinking.

The Trump administration has proposed a roughly 30% cut to NOAA’s 2026 budget, targeting climate research and ocean services that provide the rainfall and coastal data states use to model flood risk. At FEMA, the administration has cut staff by more than 6%, reduced funding for local hazard mitigation projects and added new approval layers for grants.

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For North Carolina, that means fewer dollars for buyouts, drainage upgrades and flood control projects — and less federal data to guide long-term planning — just as the state is trying to build a more forward-looking flood strategy.

Brown said North Carolina is trying to “leverage the limited dollars that we have in the state with any federal sources that are available” and embed resilience into routine investments in transportation, water treatment and conservation.

“Funding is always going to be an issue,” Brown said.

The policy gap

Researchers have long argued that resilience investments save money. Studies show every $1 spent on mitigation can yield $4 to $13 in avoided losses.

“The problem is that the policies don’t align the people who pay the cost with the people who get the benefit,” Losos said.

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A developer may not directly benefit from downstream flood reduction. A town may shoulder upfront infrastructure costs while insurers, neighboring communities or future taxpayers capture part of the savings.

Without policy changes that align costs and benefits, resilience can remain politically and financially difficult.

“In the most severe cases, there are some communities that will have to eventually abandon if they don’t begin to think about how they can adapt to these conditions,” Losos said.

North Carolina now has updated tools to better measure future flood risk. Whether the state can secure stable federal support — and align its own policies with the risks ahead — will determine how effectively communities prepare for the next storm rather than recover from the last one.

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