NC Medicaid Expansion Will Not Launch on October 1 as Scheduled


(NCDHHS) — In March, overwhelming bipartisan majorities in the General Assembly passed Medicaid expansion, finally putting us on a path to close the coverage gap and enable access to care for more than 600,000 North Carolinians. Since that time, NCDHHS has been completing the extensive policy and technical work necessary to launch expansion and working with our partners to be ready on day one. However, the General Assembly tied authority to implement Medicaid expansion to the state budget’s enactment. With budget discussions delayed, last month NCDHHS announced that if we received final authority to move forward with expansion by September 1 – either through the budget or separate legislation – we would be able to go-live with expansion on October 1. It is now clear that the General Assembly will neither pass a budget nor authorize NCDHHS to launch Medicaid expansion by this September 1 deadline. Therefore, Medicaid expansion will not launch on October 1 as we had hoped.


With the continued uncertainty around when final authority will be granted to NCDHHS, we are unable to set a new launch date at this point. We are eager to move forward with Medicaid expansion implementation as quickly as possible and while we had previously announced that the next likeliest date for expansion go-live would be December 1, we will wait for more clarity around final authority before setting a definitive date. We recognize county partners and community stakeholders have invested greatly in their readiness and the department encourages them to stay the course. We remain committed to working together to support our partners to ensure we can leverage Medicaid expansion to increase access to care across the state. 


This delay is disappointing and will tragically result in more than 600,000 North Carolinians not being able to access care when they may need it most, especially with Continuous Coverage Unwinding causing nearly 9,000 people each month to lose full health care coverage that would qualify under expansion. Nearly half of the people eligible for expansion – 300,000 people – would have been automatically enrolled in full coverage under Medicaid expansion on October 1 but now have to wait. Each month of delay costs the state hundreds of millions of dollars flowing into communities across the state to support care and treatment for people and keep providers’ doors open. Unfortunately, this delay will further strain providers who were gearing up to serve those newly eligible.


Despite this delay, NCDHHS is committed to working with our partners to prepare to enroll eligible North Carolinians on day one. 


NCDHHS appreciates the leadership of the North Carolina General Assembly and Governor Roy Cooper in securing the passage of Medicaid expansion over five months ago. We hope that we receive the authority to move forward with this historic opportunity to improve the health of North Carolinians as soon as possible.