Medicaid Cuts in North Carolina: What They Mean for SouthLight and Our Clients

How Medicaid Changes Impact SouthLight’s Mission–and How You Can Help  

By Adam Hartzell, SouthLight CEO

A Season of Growth and Urgency  

This past spring, SouthLight celebrated the grand re-opening of The SouthLight Raleigh Hub—a place of hope and healing for individuals and families facing mental health and substance use challenges. The celebration marked a major milestone for our organization and for the people we serve.

Here’s the reality of the work SouthLight does:  

• SouthLight is a leading community provider of mental health and substance use treatment in North Carolina.  
• 80% of our clients live with both mental illness and substance use disorders—a population among the most vulnerable in our state.  
• With the expansion of Medicaid, we’ve been able to double our reach—from 1,000 unique individuals per month to 2,000.  
• Clients are not only showing up—they’re getting more frequent and comprehensive care than ever before.  

But changes are coming to Medicaid that could threaten our lifesaving work.  

What’s Changing with Medicaid in 2025 

The future of Medicaid funding is uncertain—and SouthLight is facing a $2–4 million revenue shortfall in the coming year.

Looking ahead:  

On the Federal Level  

Work requirements may begin in December 2026, which could create significant barriers for the people we serve.  

Medicaid reauthorization now happens twice per year, increasing the potential for instability.  

On the State Level  

The current landscape is shifting rapidly. While Medicaid expansion has been a lifeline, state-level decisions will now determine how sustainable that support really is.  

Why Medicaid Changes Threaten Behavioral Access  

Thanks to Medicaid, and because of SouthLight’s designation as the first accredited Certified Community Behavioral Health Clinic (CCBHC) in North Carolina, we’ve launched integrated healthcare services, deepened our behavioral health support, and provided truly coordinated care to thousands.

However, with funding at risk, these gains could quickly be undone.  

Dr. Mike Lancaster (SouthLight consultant and former Chief Medical Officer) shared this key insight at a recent Coffee and Conversation event: “What I’ve seen since Medicaid expansion is simple: people who were falling through the cracks are finally getting care. We’re not just treating symptoms; we’re helping people rebuild their lives.”  

How You Can Support SouthLight’s Mission

This is more than a policy debate—it’s about real people. People who have endured trauma, addiction, and systemic barriers. People who have found hope at SouthLight. People who, without Medicaid, will lose access to the care that’s helped them survive.  

How You Can Help  

Speak up:
Contact your local and state legislators. Let them know that cuts to Medicaid will hurt our most vulnerable neighbors.  

Give what you can:
Your donation helps fill the gap left by public funding shortfalls. Donate here.  

Spread the word:
Share this blog. Talk to your networks. Awareness saves lives.  

SouthLight Has Always Been a Light in the Darkness  

For over 50 years, we’ve been a place where individuals find not just treatment—but dignity, respect, and a second chance. In times of uncertainty, we need your voice, support, and commitment to ensure that no one is left behind.  

Stand with SouthLight. Stand with those we serve.  
Let’s not turn our backs now.