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750,000+ North Carolinians to See Premiums Increase in 2026 Under State Health Plan

Premiums for North Carolina's State Health Plan will rise on a sliding scale to address a projected $500 million shortfall while adding some no-cost surgeries and lower child enrollment fees.

  • The North Carolina State Health Plan Board of Trustees on Friday approved premium increases affecting 750,000 members, effective January 2026.
  • Facing projected shortfalls, the North Carolina State Health Plan had been in dire straits, with a $500 million shortfall next year and a $1.4 billion deficit in 2027.
  • Under the new structure, premiums shift to income-based rates; employees earning $50,000 or less will pay $35, and those over $90,000 will pay $80, with deductibles doubling to $3K.
  • While most members pay more, the plan now covers all breast cancer screenings at 100%, and base plan enrollees will continue to have a $0 premium.
  • With legislative backing and a $150 million appropriation, Tom Friedman states the changes will keep the plan solvent through 2028 before the Oct. 13-31 open enrollment.
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Wral News broke the news in Raleigh, United States on Thursday, August 14, 2025.
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