BUNCOME COUNTY, N.C. (WLOS) — As open enrollment begins for the Affordable Care Act, many North Carolinians are facing double-digit premium increases and the loss of some federal assistance that helped make coverage more affordable during the pandemic.
The North Carolina Department of Insurance approved increases ranging from 16.88% to 36.4% for 2026 market plans, depending on the insurer.
Insurance Commissioner Mike Causey said the surge is related to rising health care costs and the expiration of enhanced federal subsidies that have been reducing monthly premiums starting in 2021.
“Rising health care costs and the expiration of federal subsidies have increased premiums for many people in the individual market,” Causey said in an Oct. 28 statement.
North Carolinians are bracing for increased insurance premiums as ACA subsidies expire.
Open enrollment began Nov. 1, and approximately 900,000 North Carolinians are expected to purchase 2026 coverage through HealthCare.gov before the Jan. 15 deadline.
Doug Lack, an independent insurance agent, said the increases are already being felt at his office in Arden. He’s seeing silver-level plans, the most common in North Carolina, increase by $100 a month for some customers.
“Generally speaking, we are seeing most prices rising slightly,” Lack said. “One customer had a silver plan that cost about $111 a month, and that went up to $262. Another customer went from $120 to $320.”
File image – Hospital bed in Asheville, North Carolina (WLOS staff)
Lack said the silver plan is seeing the biggest change because it is the “enhanced” option that relies the most on federal subsidies. As additional financing is phased out, consumers will have to bear more of the actual cost of coverage.
“The cost hasn’t gone up compared to the base premium,” Lack said. “It’s just a question of who pays, whether it’s a subsidy or someone out of pocket.”
For many households, this change means paying $150 to $200 more per month for the same coverage. Lack said most of his customers are trying to keep their insurance, but some are considering dropping coverage altogether.
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“Money is tight anyway. Everything costs a lot of money, and you find out that your health insurance is going to cost $150 to $200 more a month than it did last year,” Lack said.
Lack said this trend reflects a broader pattern. Medical costs, including hospital care, prescriptions and diagnostic procedures, continue to rise even as the federal subsidies that once offset those costs disappear.
Lack recommends that anyone purchasing ACA coverage compare plans early and make sure their income information is accurate to receive the correct subsidy amount.
Plans selected by December 15 will begin on January 1, 2026, and open enrollment will continue until January 15.
To learn more or compare plans, visit: HealthCare.gov.
