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The decision by North Carolina lawmakers to expand Medicaid will come with a billion dollars of new federal funds for the state. But the House and Senate disagree on how to spend the money.

North Carolina became the 40th state in the country to expand Medicaid on Monday. Gov. Roy Cooper signed the legislation into law, and support from the state’s GOP legislature could mean other red states might follow.

The Republican-controlled North Carolina General Assembly has given final legislative approval to a Medicaid expansion agreement.

For years, Republican lawmakers had opposed efforts to expand the government health care program to an additional half-million people. Tuesday’s vote is the result of changing views and a compromise with the House.

The expansion is expected to add an estimated 600,000 people who have been living without health insurance.

North Carolina has been one of a handful of states that haven’t expanded Medicaid under the Affordable Care Act.

A bipartisan group of North Carolina state lawmakers is trying again to expand the role of advanced practice nurses – a proposal closely tied to efforts to expand Medicaid.

Doctors, advocates, law enforcement representatives see the policy as a way to help the population — and the taxpayers — by keeping justice-involved people healthier.

The measure scheduled for debate in the House Health Committee would direct the state starting in 2024 to cover several hundred thousand people who would qualify for expansion under the 2010 federal health care law.