Medicaid Expansion: 600,000 North Carolinians Expected to Receive Coverage

Medicaid Expansion in North Carolina is a hard-won victory for public health, health care professionals, and everyone in our state. Advocates have been working to make this a reality since 2010 when the Affordable Care Act was passed. Legislation to expand Medicaid was approved in March 2023; however, after being tied to the passage of the state budget, it has not gone into effect until now. Last week, the North Carolina Legislature passed a budget, which will finally allow Medicaid Expansion to take effect.  

Governor Roy Cooper announced that he will let the budget take effect, but without his signature. According to the Governor, he is taking this approach to both allow Medicaid Expansion to take effect and voice his displeasure with what he has called a “bad budget.”  

Medicaid Expansion will provide timely, affordable health coverage to around 600,000 North Carolina residents in the health coverage gap. This includes residents with incomes too high to qualify for Medicaid but too low to receive health care subsidies through the Affordable Care Act marketplace. Newly eligible Medicaid recipients can expect to enroll by December 2023 or early 2024. 

What Does Medicaid Expansion Mean for North Carolina? 

Medicaid Expansion in North Carolina will: 

  • Improve the overall health, well-being, and quality of life of North Carolinians. 
  • Benefit working families, veterans, front-line workers, small business owners, parents, and many others.  
  • Strengthen economic security, create more resilient communities, and reduce uncompensated health care costs. 
  • Better support our rural health care systems and providers. 

With this map created by Care4Carolina, a consortium of health advocacy organizations, you can see the impact Medicaid Expansion is expected to have in each NC county. 

More to Do: Many North Carolinians Will Remain without Coverage or Access to Care 

While Medicaid Expansion is an important turning point, it is important to remember that there is much more work to do. Hundreds of thousands of uninsured residents will continue living without coverage, including those in our most under-served and vulnerable communities. Even with Medicaid coverage, many people will keep facing systemic barriers to accessing care, especially oral health and other specialty services.  

FHLI and our collaborative partners are here to help providers, patients, hospitals, and other stakeholders understand what Medicaid Expansion means and how to take advantage of it. If you would like to read more about the history of Medicaid Expansion in North Carolina, you can read this blog post from March 2023.  

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