ACA’s Impact on Health Insurance in North Carolina

ACA s Impact on Health Insurance in North Carolina ()

The Affordable Care Act (ACA), has had a significant impact on health insurance coverage in North Carolina. This law was implemented with the goal of increasing access to affordable healthcare for all Americans. In this article, we will explore ways in which the ACA has influenced health insurance coverage in North Carolina.

Expansion of Medicaid

One of the key contributions of the ACA was the expansion of Medicaid. Medicaid is a government-funded health insurance program for low-income individuals and families. Prior to the ACA, eligibility for Medicaid in North Carolina was limited to certain categories such as pregnant women, children, and individuals with disabilities.

States had the choice to increase the number of people who could get Medicaid. This included people with incomes up to 138% of the federal poverty level. 38 states including North Carolina have chosen to expand Medicaid. This has resulted in an increase in health insurance coverage for low-income individuals in the state.

Health Insurance Marketplace

The ACA also created a Health Insurance Marketplace. In this marketplace individuals and small businesses can shop for and compare different health plans. In North Carolina, the Marketplace is run by the federal government.

Through the Marketplace, individuals may be eligible for subsidies to help lower the cost of their health insurance premiums. This has made health insurance more affordable for many citizens in North Carolina who previously could not afford coverage.

Pre existing Conditions
Pre existing Conditions

Pre-existing Conditions

Before the ACA, insurers could reject people with pre-existing conditions. This meant that people with chronic health conditions were often unable to obtain health insurance. However, the ACA prohibits insurance companies from denying coverage or charging higher premiums based on pre-existing conditions. This has allowed individuals with pre-existing conditions in North Carolina to obtain health insurance coverage without facing discrimination.

Employer Mandate

Companies with 50+ full-time employees must provide health insurance to their employees. More employers in North Carolina now provide health insurance to their employees. According to a report by the Kaiser Family Foundation, the percentage of employers offering health insurance in North Carolina increased from 45% to 53% in 2019.


The implementation of the ACA has had a significant impact on the uninsured rate in North Carolina. According to information from the US Census Bureau, the number of people without health insurance in North Carolina went down from 16.8% in 2013 to 10.7% in 2019. This means that over 500,000 citizens gained health insurance coverage as a result of the ACA.



In conclusion, the ACA has had a significant influence on health insurance coverage in North Carolina. The ACA has made it easier for people in North Carolina to get health insurance that they can afford. It did this by expanding Medicaid and creating the Health Insurance Marketplace. It also protects people with pre-existing conditions.

While there is still room for improvement, the ACA has had a positive impact on the healthcare landscape in North Carolina.

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