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Contact: Whitney Tucker,, (803) 629-3503

RALEIGH–The opioid epidemic has devastated North Carolina families, driving thousands of children into foster care, according to a new report by NC Child. Statewide, parental substance misuse was a contributing factor to children entering foster care in 39 percent of cases in SFY 2016-17, a 50 percent increase since SFY 2007-08. The report argues that unaffordable health insurance puts treatment out of reach for many struggling to overcome opioid addiction. Closing the health insurance coverage gap could give parents the prevention and treatment options they need to provide a safe, stable environment for their children.

“Substance use disorder is a tragic disease that can tear apart families and leave children without stable, nurturing homes. The opioid epidemic is driving this crisis to a new level in our state,” said Whitney Tucker, research director at NC Child.

All children who experience trauma must overcome significant challenges, but children whose parents suffer from substance use disorder often experience even greater obstacles. These children are more likely to be placed in out-of-home care and they are more likely to stay in care longer than other children, both of which lead to poor long-term outcomes. Selina Garcia, 22, was placed in foster care when she was eight years old while her mother battled substance use disorder.

“My mother suffered from alcoholism and drug usage, so that caused me to go into foster care. It was hard but I overcame. The lack of resources from the government when it comes to mental health and substance abuse treatments for people with children is distressing. Now I’m in a position where I can now use my voice to advocate for others who are experiencing this problem, and possibly be a part of a solution to helping parents get the resources and help they need to be healthy, functioning parents,” said Garcia.

Parents suffering from substance use disorder want to provide stable and nurturing homes for their children, but they can’t do it alone. They need health insurance to access evidence-based treatment that can help them recover. Unfortunately, North Carolina’s failure to close the health insurance coverage gap has left thousands of parents uninsured. In 2014, an estimated 144,000 uninsured North Carolinians with a mental health diagnosis or substance use disorder had incomes below the income limit for expanded Medicaid eligibility authorized by the Affordable Care Act.

Donald McDonald, executive director of Addiction Professionals of North Carolina, a statewide membership organization representing the interests of addiction professionals, described the importance of health insurance for those struggling with addiction.

“Addictions specialists see individuals daily who want to recover, but who don’t have access to adequate and appropriate services. We know what causes substance use disorder and we know how to treat it and we know people get better than well. But only 1 in 10 get the help they deserve. Meanwhile, drug overdoses have doubled since 2010. Closing the health insurance coverage gap would unlock the full spectrum of addiction care–prevention, harm reduction, treatment, and recovery–which could make a substantial difference as we work to help North Carolinians find freedom and wellness,” said McDonald.

States that have closed the health insurance coverage gap are making progress. Kentucky, for instance, expanded income eligibility for Medicaid in 2014. As a result, that state saw a 700 percent increase in Medicaid beneficiaries using substance use treatment services.

HB662, Carolina Cares, is legislation sponsored by Rep. Donny Lambeth (R-Forsyth) that would create an affordable health insurance option in North Carolina for adults who currently earn too much to qualify for Medicaid, but not enough to purchase private health insurance. While HB662 includes a work requirement provision that would likely keep some people struggling with substance use disorders uninsured, overall, the proposal would boost access to needed prevention and treatment services. HB662 is not likely to move in the 2018 legislative session, but a similar bill could be reintroduced in 2019.

“Closing the health insurance coverage gap won’t end the opioid crisis, but it’s a powerful strategy that we can implement immediately to help thousands of uninsured parents get the treatment they need to keep their families together,” said Tucker.


About NC Child
NC Child builds a strong North Carolina by advancing public policies to ensure all children – regardless of race, ethnicity, or place of birth – have the opportunity to achieve their full potential.

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