North Dakota's House reluctantly voted late last month to expand Medicaid to cover more uninsured residents. Several members of the Republican-led chamber criticized the federal Affordable Care Act championed by President Barack Obama, which includes expanding Medicaid. Enough House Republicans endorsed the measure because they worried North Dakota residents would have to shoulder more costs without it.
The measure will be a much tougher sell to Senate Republicans, who have two-thirds control of the chamber.
North Dakota's Medicaid program now covers about 65,000 people a month. If the state expands eligibility, an additional 20,000 people would be added to the program.