No Budget, No Pay: Gridlock, Medicaid Gaps & Measles in WNC

North Carolina remains without a finalized state budget more than 200 days past deadline, meaning gaps in Medicaid funding, as well as delayed state programs and health services in Western North Carolina.

This week, we hear about:

In the meantime, the WNC Health Policy Initiative discussed incentives for students in the healthcare workforce, including offering housing for students closer to the workplace and the what it might mean to amend hours requirements for CNAs to enter schools to become a Physician's Assistant (PA).

For a review of health policy impacting Western NC during the first week of February 2026, this week’s update includes:

Whether you’re a community member, healthcare worker, or policymaker, this weekly briefing keeps you informed without the legislative deep dive.

What if food policy could also reduce healthcare costs, strengthen rural economies, support family farms, and build long-term resilience in Western North Carolina?

In this episode we explore how Food Hubs connect multiple regional priorities—from hunger relief and healthcare cost savings to farm viability, disaster recovery, and mental health.

Inspired by a recent conversation with epidemiologist Patrick Baron on food access post–Hurricane Helene, we turn our focus to one of the region’s newest food hubs: The Smoky Mountain Harvest Hub in Haywood County. Director Nicole Hinebaugh joins us to share how food hubs work, why they matter, and the impact of this kind of public investment.

You’ll hear:

This conversation makes the case that when policy aligns food access, healthcare, and local agriculture, the benefits ripple far beyond the initial cost.

Welcome to the first episode of the WNC Health Policy Initiative's Weekly Health Policy Update, your go-to source for updates on health policy and initiatives impacting Western North Carolina.

This week, we break down the latest emergency orders for January’s winter storms, the early impacts of HR1 on Medicaid recertification, and the end of the Legal Aid ombudsman contract.

We also highlight work from the WNC Health Policy Initiative’s three workgroup areas:

Social Drivers of Health: exploring the continuation of Healthy Opportunities alongside rural health transformation.

Healthcare Access: examining workflows for HR1’s new Medicaid recertification requirements.

Workforce Development: reviewing updated 2025 data on healthcare workforce closures

Tune in each week as we bring you to speed on policy updates and what they mean for our healthcare workforce across WNC.

Trying to get help shouldn’t feel like being passed from office to office, retelling your story, or not knowing who to call next—but for many people in North Carolina, that’s exactly what happens. Our systems of care are often fragmented, especially when needs cross aging, disability, health, housing, and family support.

One clear example is Long-Term Services and Supports (LTSS)—the services that help people live safely and with dignity when they need ongoing assistance due to aging, disability, or chronic illness, such as in-home care, transportation, caregiving support, housing assistance, and care coordination. North Carolina ranks 41st nationally for LTSS, and many residents in Western North Carolina and across the state struggle to navigate disconnected programs when they need help most.

In this episode, we explore the No Wrong Door (NWD) framework—a federal approach North Carolina is using as a roadmap (though not yet a fully built system) to better coordinate services statewide. We break down the four core NWD strategy areas:

We’re joined by longtime NWD consultant Christina Neill Bowen, Catherine Zontine of the Lewin Group, and North Carolina’s current NWD grant program manager Taylor Paré to discuss what No Wrong Door is, the essential role of Area Agencies on Aging and care coordinators, and what’s possible moving forward.

Get involved: Partners and providers of LTSS across North Carolina are encouraged to explore referral pathways, build regional partnerships, and connect with the NWD team to share insights and identify gaps. Learn more at https://nwd.acl.gov or contact us to get in touch with NC's efforts.

Episode 19: Weathering the Storm: Lessons Learned From the Healthcare Response to Helene (Part 3):

In this episode, we hear about key findings from the NC Center for Health & Wellness and Health Policy Initiative’s study, “Lessons Learned from Health Care Leaders During Hurricane Helene,” funded by the North Carolina Collaboratory. Hear from the research team about what worked, what didn’t, and the practical recommendations health care leaders say are needed to strengthen Western North Carolina’s disaster preparedness moving forward.

Special thanks to researchers Alex Mitchell and Soni Pitts. You can check out their written report in January 2026 through the NC Center for Health & Wellness.

This project is supported by the North Carolina Collaboratory at The University of North Carolina at Chapel Hill with funding appropriated by the North Carolina

You can also read more about grassroots healthcare provider response to the storm in case study: "The Mutual Aid Wellness Collective: A Case Study of Post-Disaster Mutual Aid Health Work in Western North Carolina," written by host, Andrew Rainey, 

To learn more about the Community Health Worker Evaluation, you can visit the NCCHW Collaborative Research page for audio, video, infographics, and reports. 

Listen back to Parts 1 (Episode 14) and 2 (Episode 17) back on our show page!

In Episode 18 of the WNC Health Policy Initiative Podcast, we kick off a new series on food access and health in Western North Carolina in the wake of multiple challenges to local food systems.

Joined by epidemiologist Dr. Patrick Baron, the conversation explores how factors like the end of emergency allotments in the Food and Nutrition Services (FNS) program, the impact of Hurricane Helene, federal USDA cuts, and new state policy shifts affect food access and population health.

We hear about the relationship between food security and community well‑being, and how food hubs, farms, and local infrastructure could help strengthen WNC’s safety net as federal support changes.

Read more about their report with MountainWise

In this episode of the podcast, we continue our exploration of the WNC Health Policy Initiative's collaborative study, “Lessons Learned from the Healthcare Response to Hurricane Helene” with researchers Alex Mitchell and Soni Pitts as they examine how healthcare leaders in Western North Carolina responded to the crisis.

Produced by the NC Center for Health and Wellness and supported by research funding from the NC Collaboratory, episode two of this miniseries takes a closer look at how the study was developed. We discuss the study’s design, the methods used to collect data, and the process by which researchers sought to answer questions about healthcare system readiness, communication, and coordination during the hurricane response to inform rural disaster preparedness and public health practice. 

This project is supported by the North Carolina Collaboratory at The University of North Carolina at Chapel Hill with funding appropriated by the North Carolina

In this episode of the WNC Health Policy Initiative Podcast, we sit down with political scientist Dr. Chris Cooper, Robert Lee Madison Distinguished Professor and Director of the Haire Institute for Public Policy Western Carolina University, to unpack the forces shaping health policy in North Carolina. From the role of lobbying and interest groups to the legislative process behind health-related bills currently on the table, Dr. Cooper offers a look into how policy is made.

We cover:

Whether you're a policymaker, health professional, advocate, or simply interested in the intersection of politics and public health, this conversation provides crucial insights into what’s happening behind the scenes in Raleigh and beyond.

🎧 Tune in to better understand how decisions about health policy get made that impact WNC.

In this full-length version of the WNC Health Policy Initiative podcast, we sit down with Katie Alexander and Ali Houghton from Pisgah Legal Services' WNC Health and Economic Opportunity Program to explore the impact of the so-called One Big Beautiful Bill Act on healthcare coverage. We discuss the services provided by Pisgah Legal, how this sweeping legislation could reshape healthcare access across Western North Carolina, especially for:

Listen in for insights into what this means for healthcare access in WNC and opportunities for guidance and volunteering to engage in the topic.