In 2010, President Obama signed the Affordable Care Act (ACA) into law. This act aimed to provide health insurance to millions of Americans. It created tax credits to help people pay their medical bills and made it illegal for insurers to charge higher rates for those with pre-existing conditions. Since then, over 24 million people nationwide have benefited from the ACA, including nearly one million in North Carolina—about 10% of the state’s population.
However, there’s a change coming for ACA enrollees in 2026. Coverage will become more expensive for two main reasons.
- Increased rates: In North Carolina, state officials announced an average rate hike of nearly 30% for ACA plans. Rising healthcare costs and new legislation known as the One Big Beautiful Bill Act are partly to blame.
- End of enhanced tax credits: The pandemic led to temporary increases in tax credits for ACA coverage. These credits helped many enroll in affordable coverage. In 2025, around 900,000 North Carolinians received these enhanced credits, averaging about $574 monthly. If these credits aren’t extended, many will find it harder to afford insurance.
Experts warn that if subsidies are not renewed, approximately 157,000 North Carolinians may lose their ACA coverage. Governor Josh Stein wrote to Congress, urging them to extend these critical subsidies. He mentioned that many might face steep costs for essential health insurance if nothing changes.
It’s also worth noting that DACA recipients in North Carolina will lose access to ACA coverage starting in 2026 due to the new law. As of March 2023, there were over 22,000 active DACA recipients in the state.
Looking ahead, open enrollment for ACA coverage runs from November 1, 2025, to January 15, 2026. To start coverage on January 1, 2026, you must enroll by December 15, 2025. Residents can sign up through the federal marketplace at healthcare.gov. For help, the North Carolina Navigator network is available to assist residents in finding the right plan.
The upcoming changes to ACA coverage highlight the ongoing debate over healthcare access in America. As the costs rise, many will likely voice their concerns on social media and in their communities, calling for reforms to make healthcare more affordable for all.
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