More than a decade after the Affordable Care Act was passed, more than 600,000 adults in North Carolina are now eligible to receive benefits through an expansion of Medicaid that the state, like 10 others, long resisted.
The change in policy was bipartisan, since North Carolina, a perpetual battleground state, has a government divided between Democrats and Republicans.
And while North Carolina is the most recent state to adopt the Medicaid expansion that became possible under the ACA starting in 2014, it’s potentially not the last: Republican officials in other holdout states like Alabama and South Carolina have signaled openness to the possibility .
“Medicaid expansion is not going anywhere. So why should we turn down the federal tax money that we’ve already paid in Washington? Why should we prevent North Carolinians from benefiting from that?” the state’s governor, Roy Cooper, a Democrat, told ABC News in an interview.
The expansion was signed into law in March 2023 — with nearly two-thirds of the state House’s Republicans and even more state Senate Republicans backing it — and went into effect in December, making North Carolina the 40th state to opt into the program.