UPDATE: Statement on Passage of Medicaid Expansion

News | September 25, 2023



With the passage of the 2023 North Carolina budget, the state will expand Medicaid eligibility to more than 600,000 additional North Carolinians. According to Governor Roy Cooper and the North Carolina Department of Health and Human Services, this expansion process will begin on December 1.


Implementation of Medicaid expansion reflects many years of research, community input, and analysis at the national, state, and local levels. Several North Carolina Institute of Medicine task forces have recommended Medicaid expansion as an avenue for ensuring all North Carolinians have the same opportunity for health and well-being. Click the links below for context and additional resources for navigating this significant change.


Relevant Recommendations from Recent NCIOM Task Forces:

Pandemic Preparedness, Response, and a Resilient Future for North Carolina: Recommendations from the Carolinas Pandemic Preparedness Task Force

Recommendation 8.1: Ensure access to high-quality, low-barrier health care before, during, and after public health emergencies.

Strategy 8.1a: The NCGA should increase access to and utilization of health care services for uninsured residents.


Foundations of Health and Opportunity: Investing in the Future of Local Public Health in North Carolina

Recommendation 6: Pursue innovative strategies to address broader population health and meet the organizational, funding, and workforce challenges that local governmental public health currently faces.

Strategy 6c: The NCGA should support innovation and efforts to address population health in local public health by… supporting the development of rural safety net providers by filling the Medicaid coverage gap.


Improving Serious Illness Care in North Carolina

Recommendation 3.6: Expand access to coverage for health care services.

In order to ensure access to health care services for individuals with serious illness:

  • The North Carolina General Assembly should support legislation to:
  • Close the health insurance coverage gap.
  • Ensure integration of behavioral and physical health services for Medicaid beneficiaries under Medicaid managed care.


Healthy Moms, Healthy Babies: Building a Risk-Appropriate Perinatal System of Care for North Carolina

Recommendation 3.1: Expand Access to Health Care Services The North Carolina General Assembly should increase access to and utilization of health care services for uninsured residents.


Healthy North Carolina 2030: A Path Toward Health

Expansion of Medicaid eligibility is listed as a lever for change to improve several Healthy North Carolina 2030 health indicators, including:

  • Individuals below 200% FPL
  • Uninsured rate
  • Suicide rate


From the North Carolina Medical Journal:

The Impact of North Carolina Medicaid Expansion on Young Adults, Infant/Maternal Health, and Caregiver Well-being

The Fourth Trimester: Promising Possibilities through Postpartum Medicaid Coverage Expansion


Background Resources:

Highlights of the NCGA Joint Legislative Oversight Committee on Access to Healthcare and Medicaid Expansion, Spring 2022

NCIOM Marks 10 Years of the Affordable Care Act with an Update on Implementation

The National Context for Medicaid Expansion

Medicaid Transformation vs. Expansion – What’s the Difference?

Economic and Employment Impacts of Medicaid Expansion Under the American Rescue Plan Act

What is Certificate of Need?

NC Medical Journal Shows How NC Hopes to Beat the Downward Trend in Life Expectancy

Clinical Care Health Indicators: Data & Progress Toward Healthy NC 2030 Goals