Medicaid Expansion Update: North Carolina Gets Start Date

North Carolina Governor Roy Cooper announced Monday that roughly 600,000 adults will have access to Medicaid coverage starting in December as the state legislature set a date for the program's expansion.

Cooper, a Democrat, signed a bipartisan bill into law back in March that expanded the federal health insurance program but the Republican-controlled legislature had to approve the state budget before the measure could launch. Access to Medicaid will begin December 1, and Cooper announced Monday that roughly 300,000 individuals who are currently receiving Medicaid Family Planning benefits will start receiving coverage on Day One.

"Finally expanding Medicaid in North Carolina is a monumental achievement that will extend health insurance to people who need it," Cooper said in a release published Monday. "This means better health care, including those with mental health and substance abuse disorders, hope for rural hospitals struggling to stay open and billions of dollars for our economy."

Cooper, who has served as North Carolina's governor since 2017, has fought for Medicaid expansion since he first took office. President Joe Biden also celebrated the Democratic leader's achievement on Monday, writing in a statement shared with Newsweek, "Every American deserves high-quality affordable health care."

"I commend Governor Cooper for his years of leadership fighting to get this monumental step forward for North Carolina families done," read Biden's statement. "Every day my Administration works to bring down the cost of health care for all Americans, and I'll continue to urge leaders, especially those in states who have not yet expanded Medicaid, to join our efforts."

Under the Affordable Care Act (ACA) signed by former President Barack Obama in 2010, Medicaid was expanded to be available to nearly all adults ages 19 to 64 who make up to 138 percent of the federal poverty level. As of January 2023, that includes any single person making $20,120 a year or less, according to the Department of Health. The federal government also matches 90 percent of the cost for states that expand their Medicaid programs.

North Carolina is the 40th state to expand health insurance benefits. Out of the 10 remaining states, an estimated 1.9 million people are considered to fall into the "coverage gap," meaning their incomes are too high to qualify for their state's Medicaid programs but are still considered below federal poverty levels, according to the Kaiser Family Foundation (KFF).

Republican lawmakers have consistently pushed back on the ACA since it came into existence, arguing that the law is an overstep by the federal government. In North Carolina, Medicaid expansion was passed alongside some conservative wins in the state budget bill, such as a boost to private-school vouchers for K-12 children despite family income status, reported the Associated Press (AP).

Cooper chose not to sign the budget, which received enough legislative support on Friday, immediately into law, but the measure will be enacted October 3.

"I know there's a lot of bad in the budget that they passed," Cooper said on Monday, according to AP's report.

The governor added, however, that "in this legislative circus, we can't take anymore chances on delay or defeat with the lives of so many people at stake."