North Carolina ACA Premiums Surge by Up to 36% for 2026
North Carolina has approved significant increases in Affordable Care Act (ACA) premiums for 2026, affecting over one million residents relying on marketplace coverage. The changes, which impact rates before subsidies, come amid ongoing discussions about federal funding and enhanced subsidies.
Premium Increases Overview
Next year, North Carolina residents enrolled in ACA marketplace plans will experience premium hikes ranging from 12.66% to 36.40%. The exact changes for individual ACA-compliant plans are as follows:
- Ambetter of North Carolina, Inc.: 23.40%
- AmeriHealth Caritas North Carolina, Inc.: 36.40%
- Blue Cross & Blue Shield of North Carolina: 29.36%
- Cigna Healthcare of North Carolina, Inc.: 27.49%
- Oscar Health Plan of North Carolina, Inc.: 16.88%
- UnitedHealthcare of North Carolina, Inc.: 32.27%
In the small-group market, the approved average increases are:
- Blue Cross & Blue Shield of North Carolina: 17.50%
- UnitedHealthcare Insurance Company: 12.66%
- UnitedHealthcare of North Carolina, Inc.: 14.98%
Factors Influencing Premium Increases
Multiple factors are contributing to these rising costs. The expiration of federal subsidy enhancements could lead to an average premium increase of 114% for many if not extended. Additionally, rising healthcare claims and increased costs of medical supplies have also driven the rates up.
Louise Norris, a health policy analyst, noted that some individuals might find coverage unaffordable and choose to drop it altogether. This sentiment reflects deep concerns surrounding escalating healthcare costs and economic pressures.
State Oversight and Future Projections
The North Carolina Department of Insurance plays a critical role in reviewing and approving these rate changes. Insurance Commissioner Mike Causey emphasized the necessity for consumers to begin exploring their health insurance options early, especially with the open enrollment period starting on November 1 and ending on January 15.
As stakeholders continue to grapple with the implications of these premium hikes, the political landscape surrounding federal subsidies remains tense. Negotiations between Democrats and Republicans are ongoing, with an emphasis on extending subsidies as part of a potential funding bill.
