Includes whereas clauses.

Repeals Section 3 of SL 2013-5, which prohibited expanding Medicaid eligibility.

Enacts new GS 108A-54.3B, which considers individuals as part of the Medicaid coverage gap and eligible for Medicaid benefits if: (1) the individual has a modified adjusted gross income that is at or below 133% of the federal poverty level; (2) the individual is 19 or older and under age 65; (3) the individual is not entitled to or enrolled in Medicare benefits under Part A 35 or Part B of Title XVIII of the federal Social Security Act; and (4) the individual is not otherwise eligible for Medicaid coverage under the North Carolina State Plan as it existed on January 1, 2020. Requires these beneficiaries to receive benefits through an Alternative Benefit Plan, unless that beneficiary is exempt from mandatory enrollment in an Alternative Benefit Plan under the specified federal provision. Sets copayments as the same as copayments required for Medicaid beneficiaries not under the Alternative Benefit Plan.

Directs the Department of Health and Human Services to provide coverage for individuals who are eligible for Medicaid benefits under new GS 108A-54.3B in a manner consistent with SL 2015-245, as amended (An Act to Transform and Reorganize North Carolina's Medicaid and NC Health Choice Programs). States the NCGA's intent to impose upon hospital providers paying the supplemental assessment or base assessment under Article 7A of GS Chapter 108A, a Medicaid Coverage Gap Assessment that will pay for the State share of the program and administrative costs associated with Medicaid expansion.

Effective July 1, 2021.