The uptake of the Medicaid expansion (a part of the ACA that NC has yet to adopt; currently being debated in the NC House) would help with making healthcare more affordable.

When I was a lowly Medicaid intake worker in Alamance County in 2015, I had the rarefied pleasure of calling people and telling them that they didn't quality for marketplace insurance based on the MAGI formula and let them know about extremely expensive options.

The expansion opens up an income-alone tier (as opposed to age or disability) of insurance that adds market competition that drives costs down across the board. This occurs because the private insurers have to compete with public insurance to some degree.