Compare your North Carolina coverage options with a licensed advisor. Individual, family, self-employed, and small business plans, marketplace subsidies, and enrollment help, explained in plain language.
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North Carolina residents shop for individual coverage through the federal marketplace, alongside private and employer options. Whether you are self-employed, raising a family, or running a small business, clear guidance on how coverage works in North Carolina is the first step toward a plan that fits.
North Carolina uses HealthCare.gov, the federal marketplace, rather than its own state-based exchange. Several carriers offer ACA-compliant plans, including Blue Cross NC, which is available in all 100 counties.
North Carolina expanded Medicaid effective December 1, 2023. Adults ages 19-64 with income up to 138% of the federal poverty level may qualify. Above that threshold, income-based marketplace premium tax credits can lower monthly cost.
Open enrollment generally runs November 1 through January 15. Enrolling by December 15 typically starts coverage January 1; enrolling after that starts coverage February 1. Qualifying life events open a special 60-day window any time of year.
Jordon Murphy Health is a licensed advisory firm serving North Carolina residents. We help you compare options, understand costs, and enroll with confidence, at no cost to you.
North Carolina posted the steepest ACA marketplace enrollment drop of any state heading into 2026, as premium hikes, expiring federal subsidies, and deep cuts to free enrollment assistance combined to push hundreds of thousands of residents out of coverage — though the impact landed very unevenly by county. Here's what the data shows, drawn from state insurance regulators and independent North Carolina newsrooms.
North Carolina's ACA marketplace enrollment fell from about 975,000 people in 2025 to 761,457 in 2026 — a drop of roughly 213,653 enrollees, or about 22%. That was the largest percentage decline of any state in the country, according to NC Health News and WLOS, both citing NC Department of Insurance and CMS enrollment data (February 2026).
The NC Department of Insurance approved 2026 individual ACA marketplace rate increases ranging from 16.88% to 36.4%, with a statewide average of 28.6% — announced by Insurance Commissioner Mike Causey in October 2025. Causey attributed the increases to a combination of rising health care costs and the scheduled expiration of enhanced federal premium tax credits (NCDOI press release, Oct. 2025; WLOS, Feb. 2026).
Enrollment declined in all but two of North Carolina's 100 counties. Rural Edgecombe County saw the steepest drop, falling more than 55% — from over 5,300 enrollees in 2025 to roughly 2,300 in 2026. Only Cherokee County (+26%) and Clay County (+67%), both in western NC, saw increases; the cause of those two counties' gains was not identified in the underlying analysis (The Assembly NC, May 2026).
Federal funding for North Carolina's ACA Navigator program — which provides free, in-person enrollment assistance — was cut 90%, from $7.5 million in 2025 to $750,000 for 2026. The NC Navigator Consortium reports its statewide navigator workforce shrank from 235 to 177 people as a result, even after securing about $2.4 million in philanthropic funding to partially offset the loss (WUNC/NPR, Jan. 2026).
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Learn MoreNorth Carolina's ACA marketplace enrollment fell about 22% for 2026, the largest percentage decline of any state, as the North Carolina Department of Insurance approved rate increases of up to 36.4% and federal funding for the state's free Navigator enrollment assistance was cut 90%. The impact fell very unevenly by county, so a rate hike or subsidy change that hit your neighbor doesn't necessarily apply to you. We check current pricing and subsidy eligibility for your specific ZIP code and help you re-enroll or find a lower-cost plan before your coverage lapses.
North Carolina uses the federal marketplace at HealthCare.gov rather than its own state-based exchange. Several carriers offer ACA-compliant plans there, including Blue Cross NC, which is available statewide. We help you compare marketplace and private options and choose the one that fits your doctors, prescriptions, and budget.
North Carolina expanded Medicaid effective December 1, 2023. Adults ages 19 through 64 with income up to 138% of the federal poverty level may qualify for NC Medicaid. If your income is above that threshold, income-based marketplace premium tax credits can lower your monthly cost. We check whether you qualify and help you set an accurate income estimate.
Open enrollment for North Carolina's federal marketplace plans generally runs November 1 through January 15. Enrolling by December 15 typically starts coverage January 1; enrolling after that date typically starts coverage February 1. Qualifying life events, like losing coverage, marriage, or a new baby, open a special 60-day window any time of year.
Yes. We work with North Carolina individuals, families, self-employed professionals, and small business owners across Charlotte, Raleigh, Greensboro, Durham, and Winston-Salem and statewide, matching each situation to the right coverage.
Last reviewed: July 2026. Sources: North Carolina Department of Insurance, NC Medicaid, HealthCare.gov. Rules, rates, and carrier availability change and should be confirmed with official sources at the time of enrollment.
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