While there may be “contentious” social and political conversations about a number of topics that come up as we sit around the dinner table this holiday season, one thing that we can all agree on is this: everyone in our state should have the opportunity to live long, healthy, and productive lives. Unfortunately, hundreds of thousands of North Carolinians have to deal with the challenges of managing chronic illnesses like diabetes, high blood pressure, cancer, heart disease and many, many other costly and burdensome diseases. Conditions like these place a burden not only on individuals and their families, but also on the health care system, which works to achieve the best health outcomes in the most cost-efficient manner. This is an especially challenging situation for our fellow residents struggling with adverse economic circumstances.
North Carolina has long been recognized for its innovative approaches that have been implemented to deal with the complex challenges of delivering high-quality, affordable health care, even being highlighted in the New York Times in a 2019 article about these efforts.1 In 2023, state leaders bucked the trend set by many Southern states in voting to expand Medicaid, with a highly successful campaign that has exceeded recruitment goals. Despite these efforts, North Carolina ranked 30th in the United States in 2024 in overall health outcomes, so it’s clear that more work needs to be done.2
In this issue of the North Carolina Medical Journal, leaders from across the state share their thoughts and experiences related to the role that Medicaid has played and currently plays in addressing the health of North Carolina residents, and the uncertainty surrounding the future of this program. We are grateful to have such a diverse group to come together to share their insights into an issue that is at the forefront of discussions at the state and national level. It is our hope that these commentaries will enlighten you and provide food for thought as we work collectively to move up to the top tier of healthiest states in the country.