Republican Gov. Jack Dalrymple has signed legislation to expand Medicaid to cover more uninsured residents of North Dakota.
North Dakota's Medicaid program now covers about 65,000 people a month. Dalrymple's endorsement on Tuesday means an additional 20,000 people - mostly adults without children - would be added to the program.
Medicaid expansion is a component of the federal Affordable Care Act championed by President Barack Obama
North Dakota's Republican-led Legislature reluctantly voted last week to expand Medicaid and sent the bill to the governor.
GOP lawmakers in both chambers said they felt forced to vote to expand Medicaid because of the added to costs residents if they didn't.