North Carolina Department of Health and Human Services (NCDHHS) began sending out letters last week to up to 300,000 people who are enrolled in Medicaid’s limited Family Planning program and now qualify for full NC Medicaid benefits starting Dec. 1 thanks to Medicaid expansion that was passed earlier this year by the General Assembly and fully became law with the passage of the state budget in September.

NCDHHS has been sending text messages, emails, and making phone calls, letting those eligible know to look out for a letter from their local Department of Social Services

“Getting eligible North Carolinians registered for Medicaid expansion is a top priority, and it’s monumental that we can automatically enroll up to 300,000 people whose coverage will go into effect December 1,” Democrat Gov. Roy Cooper said in a statement. “As we prepare for more people to sign up, we want to make sure automatic enrollees look for information that’s coming in the mail.”

Additionally, anyone with health coverage through will need to cancel their plan once they are enrolled in NC Medicaid. 

Some people may have income that exceeds the new Medicaid eligibility levels and may not be eligible for full NC Medicaid benefits, even though qualifying income levels are higher than in the past. 

NCDHHS Secretary Kody Kinsley said in September that the remaining 300,000 people who are eligible for Medicaid will be enrolled as they come forward to the state’s county partners.

The expansion will add hundreds of thousands of working-age, able-bodied adults to the state’s Medicaid program.

“The release by DHHS marks the first phase of implementing the largest expansion of entitlements in state history,” said Brian Balfour, senior vice president of research at the John Locke Foundation. “Unfortunately, Medicaid coverage does not mean access to care. North Carolina’s Medicaid program is already overextended, with roughly 3 million North Carolinians currently enrolled, a figure that’s up by more than a million people in the last 20 years.

Balfour said during this time, the number of doctors accepting Medicaid patients has fallen and that adding another 300,000, with more to follow, will mean that Medicaid enrollees will have significant difficulty accessing medical care in a timely manner.

The Republican-controlled legislature originally agreed to the expansion being carried out, but only if it were tied to the passage of the budget. Although unhappy with the contingency, Cooper signed Medicaid expansion into law on March 27.

Shortly after the Senate passed the budget in September, Cooper said he would let the bill become law without his signature, citing the importance of Medicaid expansion.

Kinsley said the passage of Medicaid expansion unlocked $1.6 billion in federal taxpayer-paid funds to come into North Carolina to make key investments in healthcare.

Opponents of Medicaid expansion were not happy with the outcome when the original bill was passed in the spring, saying that the bill didn’t go far enough to address supply-side problems.

Of the state’s 27 Certificate of Need laws, the expansion bill repeals only two on addiction and mental health beds, and replacement equipment up to $3 million, and repeals two CON laws for only the 23 largest counties, two to three years after federal HASP payments to the hospitals begin. N.C. remains the fourth most CON regulated state in the nation.