Issues
Healthcare
Costs.
Why North Carolinians Are Paying More Than Ever
Across North Carolina, families are feeling the strain of rising healthcare costs. Yet the cost of delivering healthcare in our state remains among the lowest in the country. North Carolina ranks 10th lowest in healthcare spending per person (KFF), and for hospital care – typically the most expensive setting – the state ranks 13th lowest in net price per inpatient discharge (Ascendient). Providers are doing their part to keep costs down, so why are patients paying more than ever?
THE FACTS
Out-of-pocket costs and premiums are rising faster than wages and inflation (KFF).
60% of North Carolinians report increased health insurance premiums over the past two years (Heal the System poll).
WHO’S BEHIND THE HIGHER BILLS?
Insurance companies are the single largest driver of what North Carolinians pay for healthcare. And North Carolinians see it clearly, with 74% blaming insurance companies for today’s high healthcare costs (Heal the System poll).
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Insurers and employers are aggressively shifting costs onto working families through rising deductibles, co-pays, and co-insurance (Ascendient).
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ACA marketplace premiums can rise sharply from year to year, and without strong affordability protections, families are exposed to insurer-driven price hikes they can’t control – impacting nearly 1 million people statewide.
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Insurers control reimbursement rates for hospitals and providers through their market leverage, giving them outsized control over what patients ultimately pay.
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Narrow insurance networks restrict access, forcing patients to use fewer providers, travel farther, or pay out-of-network rates.
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Prior authorization and coverage denials delay or block necessary care, saving insurers money while costing patients their health and financial stability.
WHY IT MATTERS
When insurance companies design plans to maximize profits instead of access, patients pay the price.
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Patients skip or delay care because they cannot afford it, even when they have insurance.
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Families lose more of their paycheck to rising premiums and deductibles.
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Small businesses can’t keep up with unpredictable insurance rate increases.
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Misleading narratives about “expensive health care” in North Carolina obscure the real culprit: how insurers structure coverage and shift financial burden.
A healthcare system where people can’t afford to use their insurance is not a functioning system. It’s a broken one – by design.
PUT PATIENTS BEFORE INSURANCE PROFITS
Lawmakers can take meaningful action to protect North Carolinians from rising healthcare costs. But we need to act on the real problem and target the true cost drivers:
Hold Insurers Accountable.
Stop them from hiding behind complex pricing structures and require full transparency on premiums, profit margins, and cost sharing.
Reform Coverage Barriers
such as prior authorizations and narrow networks that delay care, increase administrative burdens, and drive long-term costs.
Protect Working Families
from unchecked cost shifting from insurers and employers.
Stabilize the Marketplace
to prevent unpredictable premium spikes and safeguard affordable plan options.
Work with Providers
who are already keeping care costs low, instead of penalizing them based on misleading cost narratives.
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