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After a decade of debate, a deal to expand Medicaid in North Carolina was approved on Thursday, marking a significant shift for the closely politically divided state.

This move towards Medicaid expansion has been seen in several Republican-led states, including South Dakota where voters approved the expansion in a referendum last November. Advocates in Alabama are also urging lawmakers to take advantage of federal incentives to expand Medicaid coverage to more working people.

The Medicaid expansion bill, which has been championed by Democratic Gov. Roy Cooper, is expected to be signed into law soon. Once signed, North Carolina will join the majority of U.S. states that have already adopted Medicaid expansion.

Currently, there are 10 states in the U.S. that haven’t adopted expansion, while North Carolina has 2.9 million enrollees in traditional Medicaid coverage. Advocates have estimated that expansion could help an additional 600,000 adults.

However, one caveat in the final bill is that Medicaid expansion cannot happen until after the state budget is approved, which usually occurs in early summer. Cooper criticized this provision, as it may give GOP leaders leverage to include unrelated items that he strongly opposes. Despite this, Cooper tweeted that he sees Medicaid expansion as a “once in a generation investment” that will benefit all North Carolina families and strengthen the state’s economy.