Average ACA premiums to rise nearly 29% in North Carolina

RALEIGH — Health insurance rates are set to rise sharply across North Carolina, with average premiums for Affordable Care Act marketplace plans increasing by roughly 28.6%, according to Insurance Commissioner Mike Causey.

The rate hikes, approved by the N.C. Department of Insurance, apply to individual and small-group ACA policies statewide. Individual plans will see increases ranging from 16.88% to 36.4%, while small-group policies will rise between 12.66% and 17.5%.

Causey attributed the increases to rising health care costs and the expiration of federal subsidies that have helped lower premiums since 2021.

"Increased costs in health care, as well as the expiration of federal subsidies, result in premiums going up for many on the individual market," Causey said. "It's more important than ever to begin researching your health insurance options early."

Approved average rate changes for individual plans:

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%

The open enrollment period for 2026 ACA plans runs from Nov. 1 through Jan. 15, 2026. Those who enroll by Dec. 15 will have coverage starting Jan. 1, while applications completed after that date will take effect Feb. 1.

By law, rates must not be "excessive, inadequate, or unfairly discriminatory," and must align with the benefits provided. Without renewed federal support, all approved rate filings exceeded 15%.

Causey encouraged residents to explore all coverage options, including job-based insurance, private plans, or student health policies.

"Whatever you do, it is important to you and everyone to maintain health insurance," the press release stated.

Consumers can get assistance reviewing their options by contacting the Department of Insurance at 855-408-1212 on weekdays from 8 a.m. to 5 p.m.

Health insurance rates are being driven higher by several factors, including medical inflation, rising costs for hospitals and prescription drugs, and increased use of health care services.

Congressional Republicans have not yet agreed to extend the ACA subsidies, which are scheduled to expire at the end of 2025. The subsidies had reduced out-of-pocket costs for many enrollees and helped drive record participation in the marketplace. Democrats, now in the minority, are attempting to tie their extension to ongoing federal spending negotiations, a standoff that contributed to the federal government shutdown.