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North Carolina legislators passed — and Gov. Roy Cooper signed — a Medicaid expansion law earlier this year. The move will bring health insurance to some 600,000 low-income North Carolinians beginning Dec. 1. For some patients and providers, expansion can’t come soon enough.

With the expansion of Medicaid next month, North Carolina is getting a big check from the federal government. State lawmakers plan to spend more than a billion dollars on mental healthcare, training doctors and nurses — and a few projects that don’t relate to health.

Federal regulators have given their final approval for North Carolina to begin offering Medicaid to hundreds of thousands of low-income adults on Dec. 1.

For a few hours this week, it seemed like Medicaid expansion would not become a reality in North Carolina. But with final votes on the state budget expected before the weekend, health equity advocates are again optimistic.

House and Senate leaders are considering passing two bills: one with the budget, and one that launches Medicaid expansion and casinos.

N.C. Department of Health and Human Services will have to delay the expansion of Medicaid. Secretary Kody Kinsley says this delay comes because the General Assembly has not yet passed a budget.

Cooper met with elected officials and physicians in Martin, Richmond and Yadkin counties to attempt to build pressure upon Republican legislation to hustle on a budget agreement. Right now, an enacted budget law is what's blocking coverage to an estimated 600,000 low-income adults.

The General Assembly was expected to pass a state budget by July 1. Now, it could be weeks until a budget is approved and state health officials can start rolling out Medicaid expansion.

But the expansion program won't happen then unless elected officials take one last action soon. The Democratic governor signed an expansion law in March, pontentially providing health coverage to another 600,000 adults.

County Commissioners approved hiring 74 new staff positions in the Health and Human Services Department to process additional applications.