This is not surprising, given the political realities of passing the Affordable Care Act (ACA) to begin with. North Carolina and all states that touch it made the decision to dispense with expanded Medicaid, even though it was paid for in the first 3 years of its existence. Their excuses are very lame and politically motivated, but that is life. As for this author, the choice of passable healthcare should not be determined by geography in the United States of America.
The health insurance industry has been undergoing tremendous reforms in recent years due to new federal regulations including the Affordable Care Act.