The North Carolina House of Representatives gave broad, bipartisan support to expanding federally subsidized Medicaid coverage for hundreds of thousands of low-income people in the state.
Republican Representative and chief bill sponsor Donny Lambeth urged his colleagues to support expansion just as many other states have done.
"North Carolina would become the 40th state so we're not doing something here that hasn't been done already all across this great nation," he said.
Expansion enables states to extend federally subsidized health care coverage to people who otherwise might earn too much to qualify but too little to afford private insurance.
After a final vote in the House, the bill will head to the senate. Republicans there want expansion to be tied to scaling back regulatory limits on hospitals adding beds and equipment - something House Republicans oppose.