Medicaid enrollment continues to climb in North Carolina following expansion

We're nearing the six-month mark since North Carolina opened up enrollment to its expanded Medicaid program . Since December, 448,242 North Carolinians have been added to the rolls for full coverage, the state Department of Health and Human Services tells Axios.

Why it matters: The expansion meant that another 600,000 residents — nearly 6% of the state's population — became eligible for coverage they previously might not have been able to afford, from maternity care to prescription drugs.

Context: Gov. Roy Cooper has prioritized Medicaid expansion since he took office in 2017. Republicans had long been wary of expanding Medicaid benefits, initially citing financial concerns, the News & Observer reported .

• Last year, lawmakers in Raleigh reached a bipartisan agreement to expand Medicaid once a state budget was passed.
• North Carolina became the 41st state to adopt the Affordable Care Act Medicaid expansion when Cooper signed the legislation last year.

Between the lines: Medicaid signups are increasing in North Carolina's rural counties, including Edgecombe, Robeson, Swain and Graham, according to the state's Medicaid expansion dashboard .

• "Relative to the size of [the] population, we are outpacing signups in our rural communities more than urban communities," N.C. Health and Human Services Secretary Kody Kinsley recently told WRAL .
• A smaller share of the population is enrolled in large, urban counties. In Mecklenburg, for instance, 44,177 people are on the rolls — 6% of the adult population. In Wake County, the number is 27,480 people, representing 3.6% of the adult population.

Zoom out: Medicaid covers most health care services at little or no cost to patients, from emergency services to preventative care.

• Most of the prescriptions being filled under the expansion are for seizures, asthma and other chronic conditions, NCDHHS officials say.
• "Preventative, rehabilitative, services that people need and simply went without ... now will be able to benefit from," deputy secretary for NC Medicaid Jay Ludlam told Axios.
• The expansion opened up enrollment to non-elderly adults with incomes up to 138% of the Federal Poverty Level (FPL) ($34,307 for a family of three in 2023), according to the nonprofit KFF.

What's next: State health officials are working to engage with communities to get residents in need to sign up for Medicaid through town halls, distributing bilingual material, and other outreach, Ludlam says.

What they're saying: "North Carolina serves as an example to other states who have yet to expand Medicaid health care coverage, because Medicaid expansion can and will save lives," U.S. Health and Human Services Secretary Xavier Becerra said in a recent statement .