From Child Welfare To Climate: Top Nc Health Stories To Watch In 2026

By Will Atwater, Jaymie Baxley, Anne Blythe, Rachel Crumpler, Jennifer Fernandez, Rose Hoban and Taylor Knopf

Making predictions successful nan existent governmental and societal situation tin beryllium a tricky business. As nan awesome Yogi Berra quipped, “It’s reliable to make predictions, particularly astir nan future.”

Case successful point, who heard of ChatGPT astatine nan opening of 2022? By now, though, nan committedness and imaginable peril of artificial intelligence now drives galore individual decisions arsenic good arsenic nationalist policy. 

Our reporters, however, person their fingers connected nan beat of what’s happening successful wellness argumentation successful North Carolina and person a bully thought arsenic to what’s successful store, astatine slightest successful nan adjacent term. 

So, here’s what we’ll beryllium watching successful nan twelvemonth ahead. 

Following nan kid use system

North Carolina has been moving to amended its kid use system, and we’ll beryllium search its advancement successful nan coming year. A large portion of that is being capable to travel kid use cases crossed counties, something that’s agelong been connected nan wish lists of advocates and kid use workers.

In 2026, nan authorities will proceed rolling retired a lawsuit search strategy it designed pinch nan thief of workers successful nan field. The Partnership and Technology Hub, aliases PATH NC, launched successful 15 counties connected June 2. By nan extremity of 2025, each but 11 counties were utilizing nan caller strategy for intake and assessment. 

The extremity is to person each counties utilizing PATH NC for afloat lawsuit guidance by nan extremity of 2026, Lisa Tucker Cauley, head of quality services for nan North Carolina Department of Health and Human Services, told NC Health News.

Once it is afloat implemented, PATH NC will fto nan region Departments of Social Services grip intake, assessment, in-home services, foster care, adoption, financials, licensing and eligibility.

The 11 counties not yet connected PATH NC are utilizing a different automated system, which intends for nan first time, North Carolina tin spot intake and appraisal accusation for immoderate kid successful nan system, nary matter wherever they are successful nan state, Cauley said.

Cauley said PATH NC was built not conscionable based connected what is needed for automation, but what is needed to support nan workforce successful “doing bully activity pinch children and families truthful they person amended outcomes.”

However, without nan expertise for afloat ongoing lawsuit guidance crossed nan full state, North Carolina still doesn’t meet national reporting requirements, she said. 

The package rollout has gone well, and feedback remains positive, according to Cauley.

“We’re besides proceeding bully things that nan strategy creates … efficiencies for workers, which is what we wanted successful a system,” she said.

North Carolina has made a bid of moves successful caller years to amended nan kid use system, from creating a location support system and adding caller workforce training and supports, to investing successful evidence-based prevention services and providing much support for families done programs for illustration nan Bridging Families foster program. In December, nan authorities enrolled 32,000 erstwhile foster younker and children successful foster attraction successful a new Medicaid program that allows wellness attraction services to travel nan kid arsenic they move astir nan state, preventing disruptions successful care. 

The overhaul is simply a consequence of Rylan’s Law, named for 3-year-old Rylan Ott, whose tragic 2015 decease successful Moore County compelled lawmakers to make drastic changes to nan state’s kid use system.

“What’s astir important to cognize is kid use has been, since Rylan’s Law, connected a way of transformation,” Cauley said. “This strategy is simply a portion of that.”

— Jennifer Fernandez

Whooping cough cases apical 800 for 2nd twelvemonth successful NC

Just this week, NC DHHS announced that an unvaccinated kid has a presumed lawsuit of measles aft visiting South Carolina, wherever an outbreak of that illness has been spreading. The mobility is whether nan authorities will spot outbreaks of this and different vaccine-preventable diseases successful nan coming year.

Already 1 formerly-common puerility illness has been making a comeback successful North Carolina. We’ll beryllium watching whooping cough cases to spot if they commencement to driblet aft 2 years pinch much than 800 group catching nan highly contagious respiratory unwellness successful North Carolina. 

Whooping cough, besides known arsenic pertussis, rises and falls successful cycles arsenic vaccines deterioration disconnected and caller children are calved without immunity, experts said. Vaccination sum besides plays a role. In North Carolina, vaccination sum for whooping cough successful galore counties falls good beneath nan 92 percent to 94 percent level that wellness officials opportunity is important to thief extremity it from spreading among a community.

The unwellness has been connected an upswing, pinch cases rising crossed nan authorities and federation in 2023 and 2024. 

Nationally, cases began falling successful 2025, though they are still higher than pre-pandemic levels. There person been 27,871 cases successful nan United States done nan week ending Dec. 20, according to nan Centers for Disease Control and Prevention. The erstwhile year, location were 41,922 cases done nan aforesaid period.

However, national information is preliminary and sometimes recognition lags good down authorities tracking. For example, Texas is reporting much than 3,500 cases done October 2025. Federal information shows only 1,392 cases successful Texas done Dec. 20.

The South Atlantic region, which includes North Carolina, has much cases than past twelvemonth astatine this time, national information show. Most of that is driven by Florida, wherever cases person much than doubled compared pinch past year. Florida’s vaccination sum for whooping cough sits astatine astir 89 percent for school-aged children, according to national data.

In North Carolina, cases skyrocketed to 831 successful 2024 from 109 nan twelvemonth before, according to authorities information shared by NC DHHS. 

Cases successful 2025 had already topped nan full for 2024 pinch 2 weeks near successful nan year. There were 883 cases arsenic of Dec. 12, nan latest authorities information available.

Whooping cough is caused by nan germs Bordetella pertussis, and it causes an infection that tin beryllium life-threatening, particularly for infants. Babies are peculiarly susceptible because their mini airways — smaller than nan width of a pinkie digit — tin illness aft a bout of coughing. Babies besides get sick pinch whooping cough astatine higher rates than older children. 

Half of each of North Carolina’s 2025 cases are successful children property 9 aliases younger, authorities information show. 

The complaint among infants is 2.7 times higher than among school-aged children, NC DHHS said. There are 70.1 cases of infants pinch whooping cough per 100,000 residents. For school-aged children, nan complaint is 25.6 per 100,000 residents.

— Jennifer Fernandez

More changes up for reproductive, gender-affirming wellness care?

In caller years, patients person had to set to caller restrictions connected abortion access and gender-affirming attraction for minors — changes that successful immoderate cases person compelled North Carolinians to activity attraction retired of state. More limits could beryllium connected nan sky successful 2026 arsenic nan Trump management signals a continued attraction connected regulating abortion and gender-affirming care. 

We are watching national actions that could impact North Carolinians, including challenges to “shield laws,” which let licensed clinicians to supply abortion attraction — including abortion pills prescribed done telehealth — sloppy of wherever a diligent lives. Hundreds of North Carolinians, on pinch thousands much patients nationwide, person abortion pills done out-of-state telehealth providers operating nether these laws, according to #WeCount data collected by nan Society of Family Planning. 

These laws person facilitated expanded abortion access, and critics are ramping up efforts to restrict this pathway to attraction and to curtail telehealth-based abortion access.

Additionally, nan Centers for Medicare and Medicaid Services successful December unveiled a projected rule that would barroom hospitals that participate successful Medicaid and Medicare from providing immoderate gender-affirming attraction to younker — a alteration that could sharply restrict entree successful astir hospitals.

North Carolina rule already prohibits gender-affirming attraction for minors, pinch constricted exceptions for patients who were already receiving attraction erstwhile nan state’s 2023 rule took effect. Atrium Health halted this attraction for patients nether property 19 successful August, leaving immoderate families scrambling for alternatives. 

If much hospitals travel suit, options for gender-affirming attraction — which awesome aesculapian organizations see champion believe — will go moreover much limited, including successful states that haven’t enacted their ain restrictions. 

Advocates besides interest that further argumentation changes could perchance entangle entree for adults.

— Rachel Crumpler

NC prisons look staffing shortages, aging organization arsenic reentry activity continues

North Carolina has established an eager plan to amended support for group leaving situation by 2030. Last year, first woman Anna Stein named reentry and rehabilitation arsenic 1 of her privilege issues during her husband’s clip arsenic governor, adding momentum to nan effort. As 2030 approaches, we will beryllium intimately tracking advancement made toward nan goals — and nan obstacles successful its way. 

Chief among nan challenges are persistent staffing shortages astatine nan N.C. Department of Adult Correction that limit nan agency’s expertise to supply programming to nan state’s incarcerated organization of much than 32,000. 

Secretary Dismukes

Since April, situation admissions person outpaced releases, swelling nan situation organization by astir 1,400 group successful 2025, Secretary Leslie Cooley Dismukes told lawmakers during a Dec. 17 gathering of nan House Select Committee connected Involuntary Commitment and Public Safety. 

Health attraction staffing is particularly strained, pinch astir 48 percent of situation nursing positions vacant, Dismukes said. At nan aforesaid time, North Carolina’s situation organization is increasing older, driving accrued request for aesculapian attraction that will trial nan department’s resources and budget. The section projects a $63 cardinal aesculapian fund shortfall successful fiscal twelvemonth 2025-26, continuing a inclination of rising wellness attraction costs. We will beryllium examining really nan section addresses these pressures — and what they mean for reentry efforts and situation conditions.

— Rachel Crumpler

Is NC fresh for Medicaid activity requirements?

Many Medicaid beneficiaries will soon beryllium taxable to a caller norm requiring them to beryllium they are working, volunteering aliases attending schoolhouse for astatine slightest 80 hours a month.

While nan arguable alteration — a proviso of nan One Big Beautiful Bill Act signed into rule this summer by President Donald Trump — includes exemptions for seniors, pregnant women and group pinch disabilities, an untold number of “able-bodied” North Carolinians ages 19 and older are apt to suffer sum — not because they are unemployed, but because of paperwork issues.

Most of nan state’s non-exempt Medicaid recipients already person jobs, according to nan N.C. Department of Health and Human Services. But technological limitations, connection barriers and different challenges could forestall galore from regularly submitting nan archiving needed to corroborate their employment status.

There are different concerns. Jay Ludlam, caput of Medicaid for North Carolina, has said nan authorities must create a costly caller strategy to instrumentality nan requirement. That disbursal will not beryllium covered by nan national government, saddling North Carolina pinch an unfunded mandate.

Even aft that strategy is successful place, nan day-to-day activity of administering nan request will mostly autumn connected section and region departments of societal services, which are already grappling pinch staffing shortages and ample backlogs of cases.

If each that weren’t enough, Ludlam and different authorities officials person warned that nan caller activity search request could travel a trigger law forcing North Carolina to unwind its 2023 description of Medicaid. The astir 700,000 group who gained sum done description could suffer it overnight unless nan General Assembly modifies aliases repeals that trigger.

North Carolina has conscionable 1 twelvemonth to prepare. Interim national guidance is expected from nan U.S. Department of Health and Human Services successful June, and states are required to statesman outreach to beneficiaries successful September. The activity request is group to return effect connected Jan. 1, 2027.

In nan coming months, we’ll beryllium intimately pursuing really authorities leaders, region agencies and defense groups respond — and whether North Carolina tin instrumentality nan caller instruction without disrupting sum for hundreds of thousands of people.

— Jaymie Baxley

Following ongoing challenges successful nan biology space

Per- and polyfluoroalkyl substances (PFAS), commonly known arsenic “forever chemicals,” are poised to stay a awesome biology wellness rumor successful 2026. After a twelvemonth marked by emerging investigation and regulatory uncertainty, NC Health News will support search really national argumentation decisions, tribunal cases and technological findings style nan early of PFAS oversight.

In 2025, NC Health News reported connected nan U.S. Environmental Protection Agency’s connection to revise PFAS reporting requirements, arsenic good arsenic connected caller investigation showing that hard-to-detect PFAS “precursors” tin toggle shape into regulated everlastingly chemicals during nan water-treatment process — findings that raised caller questions astir really overmuch contamination whitethorn still beryllium going undetected.

That statement is apt to intensify successful nan twelvemonth ahead. The EPA is expected to finalize its PFAS reporting standards successful 2026, and lawsuits tied to PFAS contamination and accountability are winding done nan courts.

PFAS are a wide people of chemicals utilized successful user products that persist successful nan situation and nan quality body. In North Carolina, nan rumor has drawn heightened attraction since 2017, erstwhile decades of PFAS discharges from nan Chemours Fayetteville Works works into nan Cape Fear River were revealed.

People wade done PFAS-contaminated oversea foam astatine North Carolina’s Holden Beach successful October 2022. Credit: Clean Cape Fear

A Dec. 18, 2025, reside by Emily Donovan, co-founder of Clean Cape Fear, to a House Environment Subcommittee proceeding connected PFAS underscored what advocates opportunity is astatine liking arsenic nan national authorities weighs its adjacent moves.

“I raised my children connected this h2o because I thought it was bully for them — h2o should beryllium bully for children,” Donovan said. “I watched my hubby past a encephalon tumor. I besides buried friends my property who shared their illnesses pinch this very room 7 years ago. Some of america don’t person nan luxury of clip to support redirecting nan attraction distant from existent solutions.”

Other storylines NC Health News will travel successful 2026 see nan increasing conflict betwixt biology advocates and manufacture complete information centers, arsenic good arsenic nan imaginable nonaccomplishment of millions of acres of wetlands arsenic nan national authorities revises nan meaning of Waters of nan United States.

The Trump management has signaled beardown support for accelerated data-center description , moreover arsenic biology advocates pass astir nan facilities’ dense demands connected h2o and electricity. In 2023, the U.S. Supreme Court’s determination successful Sackett v. EPA narrowed national protections for wetlands to those pinch a continuous aboveground relationship to navigable waters. In November 2025, the EPA and nan U.S. Department of nan Army projected a norm change to formally instrumentality that decision.

If nan norm is finalized, critics pass that galore wetlands successful eastbound North Carolina could beryllium opened to development, expanding nan consequence of flooding and water-quality degradation. The nationalist remark play closes connected Jan. 5, 2026.

How biology rules are enforced connected nan crushed successful North Carolina will beryllium different cardinal rumor to watch successful nan twelvemonth ahead. As improvement unit grows and national protections are narrowed, ineligible challenges are expected to play a cardinal domiciled successful shaping what biology safeguards really look like.

In December, Sound Rivers and nan Southern Environmental Law Center announced a colony to extremity sediment contamination from a residential improvement affecting Martin Branch and Hurricane Creek successful Durham. The developer will salary $270,000 to nan Triangle Land Conservancy to acquisition and protect a 62-acre tract successful nan Lick Creek watershed upstream of Falls Lake, a drinking-water root for Raleigh, on pinch $30,000 successful civilian penalties and $50,000 successful lawyer fees, according to a release. 

Sound Rivers Neuse Riverkeeper Samantha Krop says protecting onshore successful this fast-growing area of southeast Durham is important to safeguarding downstream h2o quality.

“We dream that this colony serves arsenic a powerful deterrent to bad actors who recklessly harm our waterways pinch irresponsible building practices, and an unambiguous informing that contamination of our waterways will beryllium met pinch superior ineligible and financial consequences.”

— Will Atwater

Mapping intelligence wellness attraction for analyzable needs

People often scope retired to maine pinch a akin story: They person a loved 1 pinch analyzable intelligence wellness needs. They’ve tried many times to find thief for them, but thing seems to work. They’ve called mobile situation teams to their house. They’ve made trips to nan emergency room. They’ve secured involuntary commitments, which led to short psychiatric infirmary stays. Sometimes their loved one’s circumstances — specified arsenic delusions, hallucinations aliases homelessness — make them harder to reach. Other times group person recovered erstwhile curen to not beryllium helpful, and now they garbage each help.

Meanwhile, family members unrecorded successful changeless fearfulness and exhaustion, worried astir information and unsure what to do too hold for nan adjacent emergency.

In 2026, I scheme to constitute a bid of stories that asks a elemental but urgent question: What thief really exists for group pinch nan astir analyzable needs successful North Carolina and really do you entree it? I’ll beryllium digging into nan services that are often mentioned but seldom explained, from tailored Medicaid plans, to ACT and FACT teams, to early psychosis programs and adjacent support. I’ve been talking pinch wellness leaders astir what services their organizations supply and really to entree them. If you person thing you want to share, please scope retired to maine astatine tknopf [at] northcarolinahealthnews.org. 

I want this bid to beryllium applicable and focused connected nan “how-to” specifications families are hopeless for: wherever to start, who to call, what paperwork do you need, and what realistically helps group prosecute successful care. It will besides look astatine what’s missing — for illustration supportive housing, to sanction a large 1 — and why immoderate effective services are truthful difficult to find. 

Along nan way, I’d for illustration to stock profiles of group successful intelligence wellness betterment and what made a quality for them. (If you’re reference this and that’s you — nonstop maine an email.) The extremity is not to dress nan strategy useful perfectly (it doesn’t), but to representation what’s there, who it’s for and really families tin navigate it pinch much clarity. This bid won’t reply each mobility aliases connection a solution for each business — nary news article could — but I’d for illustration to springiness group a clearer consciousness of what mightiness beryllium disposable to them and wherever to begin. 

In summation to this series, I will besides beryllium paying attraction to nan new House Select Committee connected Involuntary Commitment and Public Safety, which intends to study nan involuntary committedness process and make administrative and argumentation recommendations to amended it. The committee has met twice. The adjacent gathering is scheduled for Jan. 14, and it tin beryllium viewed online. (All of nan position materials are besides astatine nan link.) 

— Taylor Knopf

Will gridlock prevail astatine nan NC legislature? 

Legislators are scheduled to return successful early 2026 for nan short convention — which traditionally is utilized to set nan biennial fund — but it’s not clear whether immoderate fund woody will materialize arsenic chambers proceed to jostle complete priorities.

There was a batch of alteration successful nan General Assembly successful 2025. Former Speaker of nan House of Representatives Tim Moore was elected to Congress, leaving abstraction for nan first caller speaker successful a decade. That spot was filled by Destin Hall (R-Lenoir), a fifth-term typical from Caldwell County. 

House Speaker Destin Hall (R-Granite Falls) said that nan House would not concur pinch nan Senate’s fund plan, which passed June 24. Credit: Grace Vitaglione / NC Heath News

Hall put his stamp connected argumentation early by refusing to budge connected immoderate of his priorities. This led to a showdown pinch Senate leader Phil Berger (R-Eden), and for nan first clip successful memory, nan 2 chambers were incapable to scope immoderate discuss connected a authorities budget.  North Carolina is nan only authorities successful nan U.S. without a spending plan.  

Without a spending scheme successful place, it’s anyone’s conjecture arsenic to what nan fund for nan adjacent twelvemonth will look like. A chaotic paper this twelvemonth will beryllium what happens during nan March primaries, wherever Berger has a beardown challenger backmost home successful longtime Rockingham County Sheriff Sam Page. Whether Berger prevails successful nan Republican superior connected March 3 will apt style nan remainder of nan year’s activity successful Raleigh.

Meanwhile, immoderate large wellness argumentation issues are unresolved. Among them are a last fund number for nan state’s Medicaid program, whether North Carolina will move up pinch building a children’s hospital, whether there’ll beryllium much money for kid attraction and what domiciled backstage equity will play successful North Carolina’s wellness attraction system. 

— Rose Hoban

Will backstage equity firms summation a foothold successful nan NC dental industry?

Republican leaders successful nan authorities Senate person shown an accrued liking successful caller years for caller laws that would allow backstage equity firms to ain and run dental practices successful North Carolina.

However, nan North Carolina Dental Society has actively lobbied against specified changes, and truthful acold nan authorities House of Representatives has not jumped connected committee pinch nan Senate’s efforts to tweak North Carolina’s dental believe business model.

As it stands now, authorities rule mostly prohibits anyone not licensed to believe dentistry successful North Carolina from owning aliases controlling dental practices successful nan state. The rule allows dentists to statement pinch guidance companies for business support if a licensed dentist maintains power of nan objective practice.

Advocates for maintaining nan existent dental believe business exemplary contend that ensuring licensed dentists ain objective practices keeps diligent attraction astatine nan forefront alternatively of allowing financial interests to thrust objective decisions.

Nationwide, backstage equity companies person been gaining a larger foothold successful nan dental industry. They travel into nan marketplace offering nan advantage of entree to superior for equipment, caller exertion and description opportunities while besides streamlining non-clinical administrative operations.

The American Dental Association issued a study by nan ADA Health Policy Institute connected Aug. 6 showing that nan number of dentists associated pinch backstage equity crossed nan state nearly doubled from 2016 to 2021. During that six-year period, dentists affiliated pinch specified organizations went from 6.6 percent to 12.8 percent.

NC Health News will beryllium keeping an oculus retired for bills introduced aliases revisited successful nan General Assembly that propose changes to nan constitution of nan North Carolina Board of Dental Examiners and action process for its members, arsenic good arsenic immoderate recommended clarifications of nan meaning of partnerships regarding nan believe of dentistry.

— Anne Blythe

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