North Carolina leaders announced Sept. 25 that Medicaid expansion will begin to roll out on Dec. 1.

The state’s legislature passed Medicaid expansion back in March. But it’s only now going into effect after lawmakers approved a months-overdue budget.

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

What does this mean for NC residents and who will be covered?

North Carolina residents between 19 and 64, who don't already have insurance, may be eligible for Medicaid coverage.

The law passed by the General Assembly expanded the income limits for single-income and double-income households. Now, residents who make up to 138% of the federal poverty level are eligible to be covered by Medicaid. That comes out to a single person who makes under $20,000 a year or a family of three making under $34,000 a year.

As of June 2023, 12% of North Carolina residents have no health insurance. That’s more than 1 million people. Of those, three in four live below the poverty line.

Researchers from the Urban Institute estimated last year that if North Carolina expanded Medicaid, uninsured rates would drop by 30% — or around 346,000 more people being covered.

Based on other states, what effect will Medicaid expansion have?

North Carolina is the 42nd in the country to expand Medicaid benefits. Gov. Cooper mentioned “hope for rural hospitals” and “billions of dollars for our economy” — what does that mean?

Simply put, Medicaid expansion may help rural hospitals financially. It’s hard to be a rural health provider; but if more rural patients have coverage, they will seek care more often, boosting numbers and profits.

A study done in Montana after Medicaid was expanded there found that an additional $600 million circulated in the state each year, supporting between 6,000 and 7,500 jobs. Cooper said he hopes there will be a similar effect in North Carolina.

Closer to home, Virginia passed Medicaid expansion in 2018. More than 400,000 people became eligible.

The uninsured rate dropped 7.2% among low-income Virginians, and new enrollees reported less financial stress and greater security for non-medical expenses like food, according to the U.S. Department of Health and Human Services.

How do I apply for coverage?

Getting coverage for yourself and your family may take up to 45 days. The application is online at ePASS.nc.gov. You can also apply in person at your local Social Security office with a North Carolina ID and a bill or other proof of address.