AfghanEvac Explainer · North & South Carolina
The Carolinas split on Medicaid. Where you live changes your options.
North Carolina expanded Medicaid in December 2023; South Carolina did not. Both cover lawfully residing immigrant children and pregnant women, and neither has a state food or health program to replace what the federal law cut. Here is what each state offers and where Afghan families can get help. Read this alongside our national explainer at afghanevac.org/obbb.
North Carolina
North Carolina: an adult pathway exists.
North Carolina expanded Medicaid, and it covers immigrant children and pregnant women, but the federal cuts still reach humanitarian adults until they adjust.
Children and pregnant women
North Carolina covers lawfully residing immigrant children and pregnant women in Medicaid with no five-year wait.
Medicaid expansion
North Carolina expanded Medicaid effective December 2023, so eligible adults, including green card holders, have a coverage pathway. Non-green-card humanitarian immigrants still lose federal Medicaid on October 1, 2026 until they adjust.
No state food or health program
North Carolina has no state-funded program to replace SNAP or federal Medicaid for excluded humanitarian adults. Emergency Medicaid, community health centers, and food banks remain. Apply and check status at ePASS (epass.nc.gov).
South Carolina
South Carolina: no adult coverage floor.
South Carolina covers immigrant children and pregnant women, but did not expand Medicaid, so adults have little to fall back on.
Children and pregnant women
South Carolina covers lawfully residing immigrant children and pregnant women in Medicaid with no five-year wait.
No adult coverage floor
South Carolina did not expand Medicaid, so low-income adults, including humanitarian immigrants losing federal Medicaid, have no adult coverage pathway beyond emergency Medicaid and, for pregnancy, the coverage above.
No state food or health program
South Carolina has no state-funded food or health program to replace what the federal law cut. Emergency Medicaid, community health centers, and food banks remain. The state refugee office is at SC DSS.
What to do in the Carolinas
Start with your state, then act early.
Because the two states differ, begin with where you live.
Apply and check status through your state portal
In North Carolina, use ePASS (epass.nc.gov) or your county DSS. In South Carolina, use SC DSS (dss.sc.gov). Ask directly which programs remain open to your status, and keep every notice.
Keep coverage for children and pregnancy
Both states cover these groups. Do not let coverage lapse, and answer any renewal notice by the deadline.
Use emergency Medicaid, clinics, and food banks
Emergency Medicaid covers emergencies regardless of status. Community health centers serve everyone on a sliding scale, and food banks serve everyone regardless of status.
Make sure you were not cut off illegally
You must get written notice before coverage ends, and you have the right to a fair hearing. If your status still qualifies, or the notice looks wrong, challenge it and respond by every deadline.
Get to permanent status
A green card is what restores federal eligibility, and in North Carolina it also opens Medicaid expansion. Use V-PRIC to see your pathway, and the organizations below to move your case.
Where to turn
Carolinas organizations serving Afghan families.
These organizations offer resettlement, benefits navigation, and legal help. Confirm current capacity before relying on any one office.
State offices and help lines
NC DHHS Refugee Services
ncdhhs.gov/divisions/social-services/refugee-services
North Carolina’s refugee office and provider directory. Apply for benefits at ePASS (epass.nc.gov).
SC DSS Refugee Resettlement
800-922-1548 · dss.sc.gov/assistance-programs/refugee-resettlement
South Carolina’s refugee office. Apply for benefits at dss.sc.gov.
North Carolina resettlement and legal help
Church World Service Durham
Resettlement and immigration services in the Triangle.
World Relief Durham
919-884-0876 · worldrelief.org/durham
Resettlement in the Triangle; World Relief Triad serves the Greensboro and High Point area.
Lutheran Services Carolinas
919-832-2620 · lscarolinas.net
New Americans services with offices in Raleigh, Asheville, and Salisbury.
Carolina Refugee Resettlement Agency (Charlotte)
704-535-8803 · carolinarefugee.org
Resettlement in the Charlotte area.
Catholic Charities, Diocese of Charlotte
Refugee and immigration services in Charlotte and Asheville.
South Carolina resettlement and legal help
Lutheran Services Carolinas (Columbia)
lscarolinas.net/new-americans-program
South Carolina’s New Americans resettlement program, based in Columbia.
World Relief Upstate SC
864-729-8655 · worldrelief.org/upstate-sc
Resettlement in Greenville and Spartanburg.
Verify before you rely. Confirm hours, capacity, and current addresses before traveling to any office, since federal funding cuts reduced staffing at many agencies.
Go deeper
The national picture, and your pathway.
This Carolinas guide sits alongside our national explainer of the One Big Beautiful Bill Act. For the full breakdown of what changed federally and how permanent status restores benefits, start there, and use V-PRIC to map your pathway.
This guide summarizes federal, North Carolina, and South Carolina policy for informational purposes and is not legal advice. It reflects the federal One Big Beautiful Bill Act (Public Law 119-21, enacted July 4, 2025) and state program rules as of September 24, 2026. Eligibility rules and programs change frequently and turn on your specific immigration category and which state you live in. Confirm your own situation with your state benefits office, a qualified immigration attorney, or a Department of Justice accredited representative. AfghanEvac is not a law firm and does not give legal advice.