Health insurance costs spike for 2026. How much more will NC enrollees pay?

North Carolinians who rely on the Affordable Care Act (ACA) could be bracing for a financial jolt next year.

Enhanced federal premium tax credits in recent years helped many enrollees enjoy unusually low monthly costs. Now those supports are shrinking.

In North Carolina, insurance companies are asking for some of their biggest rate hikes in years, driven by the upcoming end of extra subsidies and changes tied to the "One Big Beautiful Bill," according to the N.C. Department of Insurance.

The bill lets the enhanced premium tax credits that many ACA enrollees depend on expire, which means they'll no longer offset as much of the monthly premium cost, The News & Observer reported.

"There's an expectation that a lot of younger people who are generally healthy may choose to not get insurance," causing premiums to rise for those who opt in, N.C. Department of Insurance Deputy Director of Communications Barry Smith said to The Charlotte Observer.

"Maybe there's an alternative for them, where they can get another plan that's a lot cheaper," said Smith. "It may be a very high deductible, or it may not cover as much, but that's a risk they're taking."

What does that mean for your health insurance costs next year? Here's what you need to know.

In North Carolina, ACA marketplace premiums are expected to go up by as much as 36.4% for individual insurance policies and by up to 17.5% for small group policies, according to NCDOI.

The following groups can expect to see a sizable premium hike next year:

To offset the higher cost of premiums, Smith suggested those who are employed look at insurance plans through their employers.

"A lot of times, your employer will pay a good chunk of the premium for you as part of an employee benefit," Smith said, noting that the new ACA policies will not affect employer-sponsored health insurance plans.

He also pointed out that the N.C. Chamber, through a partnership with Blue Cross NC, is offering a new, affordable health plan option for small businesses with fewer than 50 employees.

Here are some other ways you can offset the cost of higher premiums, according to PBS:

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