CHARLOTTE, N.C. (AP) — Gov. Roy Cooper and health care advocates celebrated Friday’s official start of Medicaid expansion in North Carolina, the result of state legislation this year that’s expected to help roughly 600,000 low-income adults obtain the government health insurance.

Visiting a Goodwill location in Charlotte that hosted a Medicaid enrollment event, Cooper said that the gathering marked the end of “a long and winding road” for the state to agree to the Medicaid coverage offered through the 2010 Affordable Care Act, The Charlotte Observer reported.

North Carolina became the 40th state along with the District of Columbia to accept expansion since coverage began in 2014. The Democratic governor had made expansion a top priority since taking office in 2017.

“A dream a decade in the making finally becomes a reality,” he said at a news conference.

Expansion provides low-cost health care for people ages 19 to 64 who make too much money to receive traditional Medicaid but generally not enough to benefit from public subsidies available for private health insurance.

About 300,000 people receiving family planning benefits who now qualify for full Medicaid coverage under the expansion were automatically enrolled Friday, Cooper’s office said. Enrollment should grow over time as social service agencies meet with residents. Other enrollment events are scheduled across the state in the coming days.

One of the newly enrolled, Penelope Wingard, received her Medicaid card from Cooper on Friday. She described her experiences seeking care and accumulating thousands of dollars in debt when she lost health insurance while being treated for breast cancer.

“It’s like I got sick and I got punished for it,” Wingard said, adding that her tears Friday were “tears of joy.”

Carolyn Allison, CEO of the Charlotte Community Health Clinic, estimated Friday that about half of the uninsured people who visit the clinic will now be eligible for Medicaid.

Republicans who have controlled the General Assembly since 2011 had been wary for years of accepting expansion through the federal government, which covers 90% of the medical costs.

But GOP leaders recently warmed to the idea, their interest piqued in part by a $1.8 billion bonus to the state from Washington if North Carolina joined. The state’s hospitals are covering North Carolina’s 10% share. Expansion is expected to help rural hospitals financially and local economies.

Expansion legislation passed the legislature with bipartisan support in March and was signed by Cooper. In early October, the state budget was enacted — the final step before the governor’s administration could formally accept expansion from federal regulators.

“Every American deserves high-quality affordable health care,” President Joe Biden said in a statement Friday that also praised Cooper and the bipartisan support. “Today, we are one step closer towards meeting that promise as 600,000 North Carolinians can now access the affordable, quality coverage they need under Medicaid.”