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RALEIGH – Governor Roy Cooper signed H.B. 76 into law at a celebration on Monday, March 27 with a host of bipartisan support in attendance.

The bill, named Access to Healthcare Options, will expand Medicaid in the state of North Carolina. It’s expected to provide health coverage to over 600,000 people and bring billions in federal dollars to the state.

“Medicaid expansion is a once-in-a-generation investment that will strengthen our mental health system, boost our rural hospitals, support working families and so much more,” Cooper said in a press release. “This is a historic step toward a healthier North Carolina that will bring people the opportunity of better health and a better life.”

Medicaid is the public health insurance program available for people with low incomes, and helps enrollees access healthcare that they might not otherwise be able to afford. Eligibility is based on a number of factors, but for states that have already opted for Medicaid expansion, enrollees can qualify based on income alone.

According to the governor’s press release, groups that often fall into the coverage gap are veterans, early childhood educators, restaurant workers, nursing home workers, and others who may work two or more jobs to make ends meet.

It’s estimated that 40 percent of rural residents in North Carolina are more likely to be uninsured and eligible for Medicaid expansion. And statistics show that approximately 40 percent of overdose patients who go to emergency departments are uninsured, making it harder for them to receive necessary follow-up care.

Local reactions to Medicaid expansion have been positive.

“More than a decade of health care advocacy on behalf of the most vulnerable North Carolina residents has finally paid off with Governor Cooper’s signature on House Bill 76,” said Kim Schwartz, CEO of Roanoke Chowan Community Health Center (RCCHC), based in Ahoskie.

Schwartz said they will work with local and regional partners to identify who is now eligible for Medicaid coverage so that they can receive preventative medical care, affordable access to medications, and much more.

“Rural areas have felt the sting of the lack of Medicaid expansion, and I am so thankful for the passionate advocacy of RCCHC’s Board of Directors, staff, and patients who never wavered in their focus for our communities,” she concluded.

Dr. Michael Waldrum, CEO of ECU Health, called the signing a “historic day” for health care, especially in eastern North Carolina.

“ECU Health has advocated for Medicaid expansion for more than six years as we witness first-hand the challenges uninsured and underinsured patients face,” he said. “We appreciate lawmakers recognizing the importance of providing coverage for our vulnerable community members, and this landmark moment is a major accomplishment that will improve the lives of many families across the state.”

Waldrum also applauded the inclusion of the Healthcare Access and Stabilization Program (HASP) in the bill, which brings federal reimbursement funds to hospitals. He noted that Medicaid expansion and HASP funding will not solve every rural healthcare challenge, but it is important legislation to help move forward.

Michael Wray, who represents Northampton, Halifax, and Warren counties in the state house, was in attendance at the governor’s signing ceremony on Monday.

“This legislation will help the working poor who have not been eligible for Medicaid and can’t afford private health insurance,” said Wray. “This new coverage will stabilize our rural healthcare delivery network – adding critical financial support for providers and hospitals.”

Rep. Wray said that Medicaid expansion has been one of his major policy goals since 2011, and it means a great deal to finally see it enacted.

US Congressman Don Davis praised the legislation and expressed gratitude for “ensuring the stability and well-being of our hardworking families and rural hospitals.”

Davis, who represents the First District of North Carolina in Congress, also serves as co-chair of the State Medicaid Expansion Caucus that is encouraging Medicaid expansion across the country.

Several statewide organizations also celebrated the legislation.

A statement from NC NAACP President Deborah Dicks Maxwell noted that Black and Brown North Carolinians are a community that suffers from higher rates of chronic health conditions and a greater likelihood of being uninsured. Medicaid expansion will ensure equal access to healthcare.

“This collaborative effort exemplifies the power of unity in overcoming political divides to prioritize the well-being of all North Carolinians,” she emphasized.

A press release from the North Carolina Sheriff’s Association said that Medicaid expansion will help increase healthcare access for inmates as well.

“In county jails across North Carolina, both large and small, a significant percentage of inmates are suffering from substance abuse, mental health issues, and physical health issues that should be treated by medical professionals in a medical facility rather than in a county jail,” the press released stated.

The Sheriff’s Association said expanding Medicaid eligibility to this segment of the population will likely help reduce the number of people who commit crimes caused by mental or physical health issues or substance abuse issues.

North Carolina had been one of only 11 states which still hadn’t expanded the federal healthcare coverage program. According to the bill’s text, Medicaid expansion will take effect once the upcoming state budget for FY 2023-25 is signed into law. However, there is no set date for that to happen yet.

The state will receive $1.75 billion payout from the federal government for agreeing to expand Medicaid. In Gov. Cooper’s budget proposal, he suggests using a portion of that expansion bonus to create the Improving Health Outcomes for People Everywhere (IHOPE) fund, which will focus on making more mental health services available, building strong supports systems for people in crisis and with complex behavioral needs, and enabling better health access and outcomes with data and technology.

The quest for Medicaid expansion has taken some years to become reality, though Gov. Cooper has been advocating for the change since he took office in 2017. During past efforts, Republican legislators have often shot down attempts to expand Medicaid, sometimes resulting in litigation between the Republican legislators and the Democratic governor.

Recently, however, Republicans in office have become more open to the idea.

An Associated Press article quoted NC Senate leader Phil Berger on the decision, saying, “Now we have a Medicaid system that is stable. By transforming our state’s Medicaid program, we’re now in a place where our system can handle those additional enrollees.”