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, state health officials announced on Friday.

The Centers for Medicare & Medicaid Services told the state in a letter Thursday that changes to North Carolina’s Medicaid program to provide expanded coverage through the 2010 Affordable Care Act had been approved.

An estimated 600,000 adults age 19-64 who earn too much for traditional Medicaid but too little for subsidized private insurance are expected to benefit in North Carolina. About half of that total should be enrolled immediately, the state Department of Health and Human Services has said.

“Expanding Medicaid is a monumental achievement that will improve the health and lives of hundreds of thousands of people while helping our health care providers and economy,” Gov. Roy Cooper said in a DHHS news release announcing the approval of the State Plan Amendment, which is designed to show the state is equipped to handle the influx of additional federal funds.

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North Carolina Medicaid expansion is still set to start on Dec. 1 as federal regulators give final approval. 

The General Assembly passed and Cooper signed in March a Medicaid expansion law, but a state budget also needed to be approved before expansion could be implemented. A two-year budget law took effect earlier this month.

DHHS had been working so that the enrollment start could be accelerated once the budget law was enacted. Federal regulators received the State Health Plan amendment proposal on Aug. 15, according to Thursday’s letter. Cooper and DHHS Secretary Kody Kinsley announced the Dec. 1 start date nearly three weeks ago.

To qualify for coverage, for example, a single person can make up to $20,120 annually in pretax income, while a household of four can make up to $41,400 for an adult to benefit.

County social services offices will help enroll residents who qualify for Medicaid expansion beyond the first tranche of 300,000 who already have limited Medicaid family planning coverage and will be enrolled automatically. DHHS has created a website with information on expansion for consumers and groups that aims to locate potential recipients.