North Carolina
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.
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.
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?
Dr. Mandy Cohen and Kody Kinsley are former Secretaries, NC Department of Health and Human Services.
North Carolina
NC offshore wind project canceled as $1B deal shifts investment to fossil fuels
A planned offshore wind project off North Carolina’s coast that could have powered roughly 300,000 homes has been scrapped after the federal government agreed to spend nearly $1 billion to halt its development, a decision that is drawing sharp reactions and raising questions about future energy costs in the state.
Under the agreement, the French energy company TotalEnergies will be reimbursed for leases it purchased in federal waters near Bald Head Island. In exchange, the company will redirect that investment into oil and natural gas projects, including liquefied natural gas (LNG) production.
The move comes as electricity demand in North Carolina and across the Southeast is rising, driven by population growth and the rapid expansion of energy-intensive data centers.
Energy analysts say removing a major potential source of power from the pipeline could have lasting implications.
“I think folks are trying to figure out how to reconcile this with the fact that we do need more electrons on the grid,” said Katharine Kollins, president of the Southeastern Wind Coalition. “Every state right now is looking at how we can develop more energy, not how we should be taking options off the table.”
The canceled project, known as Carolina Long Bay, was one of two offshore wind developments TotalEnergies had planned along the East Coast. The North Carolina portion alone would have generated about 1,300 megawatts of electricity and brought significant economic development to the region.
State leaders were quick to criticize the decision. In a post on X, Gov. Josh Stein said the Trump administration is “spending nearly $1 billion in taxpayer money to pay off a company to stop investments in the clean energy we need,” calling it “a terrible deal for the people of North Carolina and our country.”
The Interior Department, which negotiated the agreement, defended the move, saying offshore wind projects are too costly and unreliable to meet the nation’s energy needs. In a statement, officials said redirecting investment toward natural gas would provide “affordable, reliable and secure energy” while strengthening grid stability.
The debate reflects a broader divide over how to meet growing electricity demand while keeping costs down.
Offshore wind projects typically require high upfront investment but have no fuel costs once operational. Fossil fuel plants rely on fuel that can fluctuate in price.
“Using a billion dollars of taxpayer money to remove an option for North Carolina and then require that company to invest in LNG just doesn’t feel right,” Kollins said.
She and other advocates argue that offshore wind could help stabilize energy prices over time by diversifying the state’s power mix, particularly during periods of high demand or fuel volatility.
The federal government and industry leaders backing the deal say natural gas offers a more dependable source of power, especially as the grid faces increasing strain.
Part of that shift now points to LNG, which is traded on a global market. That means prices can rise or fall based on international demand, geopolitical tensions and export levels — dynamics that do not affect wind energy.
The cancellation also highlights uncertainty around offshore wind development in North Carolina. Duke Energy, the state’s largest utility, holds a neighboring lease in the same area but paused development last year as it reevaluated costs and policy conditions.
As state regulators and utilities map out how to meet future demand, the loss of Carolina Long Bay narrows the range of options.
For residents, the stakes may ultimately show up in monthly bills.
“When we limit our choices,” Kollins said, “we limit our ability to control costs.”
North Carolina
What North Carolina Wants to See Happen in the Sweet 16
The North Carolina Tar Heels were a first-round exit in this year’s NCAA Tournament, but that does not mean that what transpires the rest of the way does not matter for the program.
It has been less than a week since the Tar Heels blew a 19-point lead in the second half against the VCU Rams, en route to an 82-78 loss in overtime. The result has raised doubts about Hubert Davis’ future as North Carolina’s head coach.
With all of that being said, here are a couple of things the Tar Heels should be wishing to happen later this week in the Sweet 16.
Duke Falls Short
The North Carolina-Duke rivalry is arguably the best one in all of sports. It was a tantalizing matchup the first time these two squared off this year, with Caleb Wilson and Cameron Boozer going head-to-head, as both players are expected to be selected in the top five of the 2026 NBA Draft.
However, the discrepancy between the two teams was apparent, even though the Tar Heels split the season series. The Blue Devils entered the NCAA Tournameent as the No. 1-overall seed in the entire field, while the Tar Heels limped into the field as a six-seed.
While North Carolina would obviously prefer playing in the upcoming round, which starts on Thursday night, nothing would make Tar Heels fans happier than to see Duke fall to St. John’s in the Sweet 16.
The Blue Devils have been playing with fire in the first two rounds, at various points, but they ultimately advanced to the second weekend of the tournament. St. John’s is a formidable opponent that could legitimately take down Duke.
One of the Teams With a Legitimate Head Coaching Option To Lose
It has been well-documented that North Carolina is likely to be in the coaching market, as Davis appears to be on his way out in Chapel Hill. If this occurs, the Tar Heels need to make a substantial hire that will elevate the program back to competing for national championships.
There will be a slew of options for North Carolina to consider, but two names to keep an eye on are Iowa State’s T.J. Otzelberger and Alabama’s Nate Oats. You may be asking yourself, ‘Why should North Carolina be rooting for potential head coach candidates to lose?’
Here’s why: the transfer portal opens on April 7, and ideally, North Carolina would want its presumed new head coach in place well before then. Those coaches will not be the only two to watch for, but they are arguably the most ideal.
North Carolina
AG Jeff Jackson wants the president to negotiate change from Chinese apps that fund fentanyl
North Carolina’s top prosecutor is asking the president for
help in the fight against fentanyl. Attorney General Jeff Jackson says
criminals are using Chinese apps to launder millions of dollars which fund
the fentanyl epidemic in the US. He thinks the president can negotiate a
change.
The effort hits home for the Nash family. This past weekend
marked four years since Jeff Nash lost his daughter, Amanda.
“It was a tough weekend. It was. I don’t think it gets
any easier,” Nash told WRAL.
Nash is one of thousands of fathers who knows what it feels
like to lose a child to fentanyl. And he knows what people will say…
“His daughter should have known not to do it. No one
forced her to do it. She was a grown woman. She was an adult who made her choices
and this was the natural consequence of her choice. And to say that would be
right. I understand that. However, two things can be right. It also is right for
our federal, state and local governments to do everything they can to keep this
poison away from our people,” Nash said.
Fentanyl is the primary driver of the opioid crisis in North
Carolina, contributing to over 75% of fatal drug overdoses in recent years. But
a small change gives cause for hope. 2025 and early 2026 data from the state office
of the medical examiner indicate a potential decline in fentanyl-positive
deaths for the first time in years.
North Carolina Attorney General Jeff Jackson said there is
still work to do.
“We’re losing six people a day. I’ve spoken to a lot of families
who have lost people. I told them I’ll do whatever I can and one thing I can do
is go after the money. If you go after the profitability of a crime, you’ll
reduce the prevalence of that crime,” Jackson said.
More than $100 million a week flow through Chinese owned
apps to support the sales of fentanyl in the US, Jackson said.
Over the last year, his office got one app called WeChat
to agree to be more responsive with investigators and make encrypted spaces on
the app more hostile to fentanyl money laundering. But its sister app, Weixin is
not subject to US laws and wants the White House to take action.
In a letter to the president, Jackson and five other
attorneys general from Colorado, New Hampshire, New Jersey, Kentucky and South
Carolina urged the president to take action. It states that despite the agreement
with WeChat to work with investigators, neither it nor Weixin agree to share
data from the ap.
“In practice, this means that law enforcement can only see
one side of illegal transactions, shielding Chinese-based users from justice,”
the letter said.
Nash wondered why only six attorneys general would support
the effort. Jackson said the focus was to get a request to the president that
was not political, bipartisan and clear.
He believes President Trump has the ability to negotiate with the
Chinese to effect change when it comes to money changing hands through its
apps.
“I think we recognize that the Chinese government is
different than the American government and if the leader of China decided to
make a change, that change would be made,” Jackson said.
Nash was reluctant to revisit his pain discussing his
daughter’s death, but said it’s worth it if this letter gets people talking or
gets any government movement to reduce the flow of fentanyl into the US.
Nash was one of the subjects in the WRAL documentary, ‘Crisis
Next Door – The Fentanyl epidemic.’
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