The Obamacare rollout has been almost universally problematic, but North Carolina is having a particularly rough time, which could spell trouble for Senator Kay Hagan (D., N.C.), who is beginning to look vulnerable heading into 2014.

The state is experiencing many of the problems typically associated with the controversial law. Local businesses are cutting hours; individuals (at least 160,000 of them) are losing their existing insurance plans and now face premium costs that have more than doubled as a result of Obamacare. In some cases, premiums have jumped by more than 400 percent, and federal subsidies aren’t nearly enough to offset to the cost.

North Carolina is particularly vulnerable to cost increases because one company — Blue Cross Blue Shield (BCBS) — dominates much of the health-insurance market in the state, serving more than 3.7 million customers. But the company has encountered a series of problems with the federally administered exchange, enrolling only one person in the first month, and that individual has yet to pay for coverage and so therefore is technically not in the system.

Fewer than 1,000 people have even filled out applications through the exchange, but the government website has proven so flawed that BCBS has declined to upload any data, out of fear that doing so would result in the introduction of incorrect information into its computer system. Some families have been unable to sign up for coverage despite weeks of trying to access the exchange via the website, by phone, and even by mail.

None of this is good news for Hagan, who was swept into office in 2008, when Barack Obama became the first Democrat to win North Carolina since Jimmy Carter in 1976. Democrats had been reasonably confident about defending Hagan’s seat in 2014, says John Hood, president and chairman of the John Locke Foundation, a Raleigh-based think tank. However, the Obamacare rollout “is putting the first fear in Hagan’s camp that we’ve seen. She is vulnerable pretty much because of this issue.”

She can expect to face withering attacks from Republicans over her support for the law as well as for repeating President Obama’s notorious pledge that individuals who like their health-insurance plans would be able to keep them. “Whatever we do, I don’t want to dismantle any system where people are happy with the coverage that they have,” Hagan said at a rally in June 2009.

Obama recently somewhat apologized that people losing coverage “are finding themselves in this situation based on assurances they got from me.” Meanwhile, Hagan has signaled some atonement of her own, lending support to a proposal from another vulnerable incumbent, Senator Mary Landrieu (D., La.), which seeks to expand the provision of Obamacare that allows certain existing plans to be “grandfathered” into the new system. It’s an intriguing proposal. In fact, Republicans proposed similar legislation in September 2010, but Hagan and Landrieu joined their fellow Democrats in unanimously rejecting the plan.

According to recent polling conducted by the state’s free-market Civitas Institute, Hagan’s approval and favorability ratings remain in positive territory, but there are still plenty of data points that should be of concern to Democrats, perhaps none more than the dearth of support for Obamacare in the state. According to one poll conducted in late October, 54 percent of North Carolinians oppose the law, compared with just 36 percent who support it. Much of the opposition (45 percent) comprises people who “strongly oppose” the law, with the most common complaint among opponents being that the new reforms will lead to higher costs, something many North Carolinians are already experiencing firsthand.

“Voters may not be mad at Kay Hagan personally, but policies like Obamacare are having a bad impact, and that’s beginning to sink in, which ought to alarm her,” says Jim Tynen, director of communications at Civitas.

According to the same poll, only 30 percent of voters think Hagan deserves to be reelected, with 50 percent favoring someone else. A High Point University poll released in early October, conducted before the rollout of the Obamacare exchanges, found that just 19 percent thought Hagan should be elected, with 56 percent favoring a replacement.

The challenge for Republicans will be to choose an acceptable replacement. The party faces a crowded and potentially contentious primary, even after many prominent lawmakers declined to enter the race. Whoever wins the GOP nomination — North Carolina house speaker Thom Tillis is the early frontrunner — would do well to make Obamacare the central issue in the campaign. Hood says that Democrats may ultimately be right to say that the long-term political consequences of the Obamacare-exchange debacle might turn out to be relatively mild, but hastens to add: “I don’t think ‘long term’ is November 2014.”

— Andrew Stiles is a political reporter for National Review Online.