Medicaid Expansion in North Carolina
Tuesday, September 26, 2023
North Carolina Medicaid expansion

North Carolina Governor Roy Cooper announced on September 22, that the state’s $30 billion budget bill will become law and effective on October 1. The budget bill funds the North Carolina Medicaid expansion agreement that was signed in March, but was pending budgetary approval before Medicaid coverage could be implemented by the Department of Health and Human Services (“DHHS”).[1] The Medicaid expansion legislation does not include a specific date when eligibility rules will change, but Governor Cooper and DHHS Secretary Kody Kinsley announced in a press conference on September 25 that DHHS will launch expansion on December 1.[2]

North Carolina previously had been in the minority of states that had not expanded Medicaid under the Affordable Care Act. While there are currently 2.87 million Medicaid recipients in North Carolina, the expansion will allow around 600,000 additional individuals to gain health insurance through Medicaid. The expansion loosens eligibility requirements by raising the maximum allowed income to 138 percent of the federal poverty level, which is about $20,120 a year for a single adult (aged 19 to 64) or $41,400 for a family of four.[3]

[1] Access to Healthcare Options, H.B. 76 / SL 2023-7, North Carolina General Assembly (2023-2024).

[2] NC Medicaid Expansion Will Launch on Dec. 1, 2023, DHHS, (accessed Sept. 25, 2023).

[3] HHS Poverty Guidelines for 2023, ASPE, (accessed Sept. 25, 2023).


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