Medicaid: Why it Matters

“Let’s not roll back progress. Let’s keep pushing forward—because lives depend on it.” —Adam Hartzell, CEO

We’re in the middle of a serious substance use crisis across the country, and North Carolina is no exception. In 2023 alone, more than 100,000 Americans died from drug overdoses, with opioids behind the majority of those tragic losses. 

At SouthLight Healthcare, we see the reality of this crisis every single day. We’re proud to be the largest single-site opioid treatment clinic in North Carolina, with more than 860 people walking through our doors for treatment daily. These are our neighbors, our friends, our family members—and for many of them, Medicaid is the only way they’re able to get help. 

Medicaid Expansion Has Been a Game Changer 

When North Carolina expanded Medicaid in December 2023, it opened the door for over 600,000 more people to get health coverage. That expansion has had a powerful and immediate impact here at SouthLight. Before the change, approximately one-third of our clients had Medicaid. Now? It’s 63%. That’s hundreds more people getting the help they need—people you might pass at the grocery store, the gas station, or your child’s school. 

Thanks to Medicaid, they now have access to proven, life-saving treatments for opioid use disorder (OUD), including: 

• Medication-assisted treatment (MAT) — including buprenorphine, methadone, and naltrexone
• Counseling and behavioral health support  
• Harm reduction tools like naloxone and syringe services 

These services don’t just save lives, they save money, reduce ER visits and incarceration, and help people get back to work, school, and their families.  

Why Continued Support Matters 

Unfortunately, there’s a real threat to everything we’ve gained. Lawmakers—including many in North Carolina—have voted to cut Medicaid funding.  

If coverage is reduced or becomes harder to access, here’s what can happen: 

• Clinics like ours may be forced to limit services 
• Waitlists could grow longer 
• More people will fall through the cracks, and some may not make it back 

When treatment isn’t available, emergency rooms and jails become the default option. That’s not just ineffective—it’s expensive and unsustainable. 

Work Requirements Are a Hidden Barrier 

Some policy proposals are pushing for work requirements to qualify for Medicaid. While the intent may be to encourage employment, the reality is that such requirements often create barriers for individuals in recovery, people who are actively working to rebuild their lives. They may be between jobs, working part-time, or just trying to get stable. The reality is, losing coverage during recovery can be deadly. 

Evidence from other states shows that these requirements can lead to fewer people receiving care, with no real boost in employment. 

NCDHHS cited the potential impact: In North Carolina, work requirements could cause an estimated 88,000 people (up to 123,000 under high-end estimates) to lose Medicaid coverage in the first year alone. Over 10 years, that number could grow to 156,000 (up to 218,000), resulting in a $14 billion loss in federal Medicaid funding if implemented in 2027.   

Medicaid Is a Smart Investment in Our Future 

Every dollar spent on treatment through Medicaid saves up to $7 in other costs, such as emergency care, policing, and lost productivity. When people get the help they need: 

• Overdose deaths go down 
• Families stay together 
• Communities become safer and healthier 

At the end of the day, Medicaid isn’t just a safety net—it’s one of the most effective tools we have to fight addiction and strengthen our communities. 

Let’s not roll back progress. Let’s keep pushing forward—because lives depend on it.

What You Can Do

NCDHHS is encouraging us to engage federal lawmakers, community leaders, and benefit recipients in raising awareness of the impact of these federal changes and cuts. 

The decisions being made about Medicaid will impact real people in our neighborhoods and across the state. We encourage you to: 

• Stay informed about Medicaid and behavioral health policy developments 
• Share your story if Medicaid has helped you or someone you love 
• Support organizations like SouthLight that work every day to expand access to care for those who need it most 

Together, we can protect the progress we’ve made—and ensure more North Carolinians get the chance to recover, rebuild, and thrive. 

About SouthLight Healthcare 

Founded in 1970, SouthLight Healthcare is a nonprofit behavioral health provider offering accessible, evidence-based mental health and substance use treatment across Central North Carolina. Serving more than 5,500 individuals and families in Wake, Durham, Cumberland, and Harnett Counties, SouthLight delivers a full continuum of outpatient and community-based services—including therapy, psychiatry, medication-assisted treatment, peer support, prevention programs, and integrated care. 

As Wake County’s first and only Certified Community Behavioral Health Clinic (CCBHC), SouthLight is committed to delivering high-quality, integrated care with a focus on accessibility, accountability, and innovation. To learn more or make an appointment, call 919-787-6131 or visit www.southlight.org.