How many people are enrolled in Affordable Care Act plans in North Carolina?
Refreshed annually
About 761K in 2026 (based on numbers from open enrollment period, which typically runs from early November to mid-January of the next year). That’s roughly 1 in 15 people, or about 6.8% of North Carolina’s population. North Carolina enrolls similar residents than average: enrollment nationally averaged about 6.8%, and North Carolina ranked 10th among all states and Washington, DC.
761K
enrolled in qualified health plans (2026)
6.8%
of the states population enrolled in qualified health plans (2026)
In 2015, 5.7% of North Carolina residents were enrolled in a qualified health plan through the Affordable Care Act (ACA), often called "Obamacare," both inside and outside of government. Enrollment rose to 6.2% in 2016; by the 2022 plan year, the first open enrollment period after the temporary expansion of ACA tax credits, it went up to 6.3%. The largest year-over-year increase occurred between 2023 and 2024, when enrollment grew by 2.0 percentage points, before peaking in 2024 at 9.5%.
In 2026, the share of North Carolina's population enrolled in an ACA health plan was 0 percentage points higher than the national average.
Estimated share of the population enrolled in qualified health plans, by year
How many ACA enrollees in North Carolina are new to the marketplace?
Enrollment changes reflect both new people buying ACA insurance for the first time and returning customers re-enrolling. In North Carolina, re-enrollees made up a larger share of enrollment than new consumers starting in 2016 — a trend that continued through 2026. In 2026, re-enrollees accounted for 83.5% of enrollment, while new consumers made up 16.5%.
In 2026, 83.5% of ACA enrollees in North Carolina were returning consumers, while 16.5% were new to the marketplace.
Share of qualified health plan enrollment in North Carolina by new consumers and re-enrollees, 2015–2026
How many enrollees in North Carolina receive ACA financial assistance?
There are several mechanisms that can lower the costs of ACA plans. Eligible individuals can apply for an Advance Premium Tax Credit (APTC) to reduce their monthly premiums; at year's end, their actual income determines whether they must repay excess credit or receive additional funds. There are also cost-sharing reductions that lower deductibles, copayments, out-of-pocket maximums, and coinsurance.
In North Carolina, 87.1% of the people enrolled in qualified health plans received an APTC and/or cost-sharing reduction in 2026, 0.4 percentage points more than the national rate of 86.7%.
In 2026, 87.1% of ACA enrollees in North Carolina received financial assistance.
Percentage of people enrolled in qualified health plans receiving APTC and/or CSRs, 2026
What is the average APTC in North Carolina?
The average APTC in North Carolina was $660, higher than the national average of $650 by $10, a 1.5% difference.
In 2026, North Carolina's average APTC was 1.5% higher than the national average.
Average APTC among consumers receiving APTC, 2026
How much do APTCs reduce monthly premium costs in North Carolina?
APTCs lowered the average 2026 premium in North Carolina from $755 to $180, a reduction of $575, or roughly 76.2%.
In North Carolina, 2026 APTCs reduced the statewide average premium from $755 to $180.
Average premium and average premium after APTC in North Carolina, 2026
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Methodology
USAFacts standardizes data, in areas such as time and demographics, to make it easier to understand and compare.
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USAFacts endeavors to share the most up-to-date information available. We sourced the data on this page directly from government agencies; however, the intervals at which agencies publish updated data vary.