North Carolina: Updated: ACA Medicaid expansion for 600K to finally happen after all starting December 1st!

Back in March, after years of failed and stalled attempts to get it passed, the North Carolina legislature finally pushed ACA Medicaid expansion over the line to be signed into law by Democratic Governor Roy Cooper.

As for when the program would actually go into effect, however...that's been something of a mystery for awhile now. Apparently the wording of the legislation ties it in with it being included in the general state budget, which wouldn't be voted on or approved for months. As a result, no one seemed to be sure when the healthcare expansion program for up to ~600,000 North Carolina residents will actually launch.

Back in July, the Health & Human Services Dept. took an optimistic stance, preparing for the possibility of the program kicking off starting on October 1st of this year. Unfortunately, that was based on the assumption that the GOP-controlled state legislature would actually pass the general budget required for it to happen by September 1st...which didn't happen.

Then, just a few days ago, the Republican-controlled state legislature decided to attempt to take Medicaid expansion hostage in order to force legalized casinos on the state.

Fortunately, after a massive backlash from both Democrats (who have zero control over the legislation, since the GOP has a supermajority), independents and even some of their own party, it looks like state Republicans decided to take a pass on the casino scheme after all:

North Carolina's $30-billion budget, stuffed with Republican priorities but also containing a long-sought Democratic victory on Medicaid expansion, will become law without Gov. Roy Cooper's signature, he announced shortly after the GOP-held Senate gave final legislative approval Friday morning.

The budget, delayed by Republican disputes over expanded gambling in the state, comes months after the July 1 start of the fiscal year.

The expansion of Medicaid, a top issue for Cooper since he was first elected governor in 2016, will give health insurance to hundreds of thousands of the state's working poor. Expansion passed previously in the session, but its implementation was tied to the budget.

"Health insurance for 600,000 more North Carolinians that brings more mental health and substance use disorder treatment, help for desperate rural hospitals and billions of dollars into our economy is a life-saving, monumental decision for our state," Cooper said in a statement moments after the Senate passed the measure in a 26-17 final vote Friday morning.

"Make no mistake, overall this is a bad budget that seriously shortchanges our schools, prioritizes power grabs, keeps shady backroom deals secret and blatantly violates the constitution, and many of its provisions will face legal action."

...however, in the end, it looks like Cooper decided that locking in healthcare coverage for up to 600,000 residents was more important than the negatives...and again, it's not like he has much power to stop the other stuff anyway, since the GOP could override his veto if necessary.

In any event, it's done. I'm not sure if Medicaid expansion will actually launch in November, December or January, but it will be within the next 100 days.

UPDATE: WRAL News confirms that the program will go into effect starting December 1st, 2023:

Medicaid expansion will go live on Dec. 1, North Carolina Gov. Roy Cooper governor said, providing free health insurance for the state's working poor.

...Medicaid expansion would have launched Oct. 1 if budget negotiations didn’t draw out through the summer. Gov. Cooper called the measure "life-saving healthcare for North Carolinians."

...DHHS anticipates approximately 300,000 eligible people currently receiving Medicaid Family Planning benefits will automatically be enrolled in full health care coverage. The expansion increases the eligible population to adults aged 19 to 64 who have incomes up to 138% of the federal poverty level.