Governor Cooper never stopped fighting for Medicaid expansion. After a decade of work, Medicaid expansion launched in North Carolina on December 1, 2023. Thanks to months of planning prior to launch, the state was able immediately to enroll nearly 300,000 people who had been receiving Medicaid Family Planning benefits. At the time of launch, it was estimated that it would take two years to enroll 600,000 newly eligible individuals and families into Medicaid. Thanks to Governor Cooper, Secretary Kinsley, state partners, community-based organizations, local advocates and other trusted messengers, North Carolina has reached more than 600,000 enrolled in just one year, half the time that was projected.

• After enacting Medicaid expansion, it became clear that many North Carolinians were still suffering under the burden of medical debt. Governor Cooper and NCDHHS worked with hospitals and other stakeholders to create a first-of-its-kind medical debt relief program that will relieve $4 billion in existing medical debt for nearly two million of low and middle-income North Carolinians and ease the burden of medical debt in the future.
• The program offers enhanced Medicaid payments from the federal government in exchange for relieving certain medical debt. All of the state’s 99 eligible hospitals have signed on to the state’s innovative plan, and states across the country can now look to North Carolina for a roadmap on how to help.

• During his two terms, Governor Cooper prioritized investing in mental health resources and support. Through Medicaid expansion, the Governor and NCDHHS secured a transformative $835 million investment in mental and behavioral health to make it possible for more North Carolinians to receive care when and where they need it.
• This monumental investment will help ensure that people’s behavioral health needs are better met by funding services for people experiencing a mental health or substance use crisis, helping individuals with behavioral health conditions avoid incarceration, helping children with complex needs and supports for families and strengthening the behavioral health workforce.

• In 2022, Governor Cooper and NCDHHS launched the Healthy Opportunities Pilots, a first-in-the-nation effort to recognize that supporting health doesn’t just happen at the doctor’s office or in a hospital. The program invests in non-medical support related to housing, food, transportation and more for high-needs Medicaid recipients.
• Early findings on this innovative program show that it works by saving money and keeping people healthier. Participants saw decreased rates of hospitalization and significantly lower health care spending. Two years into the pilot, the state is spending about $85 less in medical costs per beneficiary per month.