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North Carolina Faces Rising Health Care Costs: What You Need to Know

by Shreeya

Health care costs in the United States vary widely by state, with North Carolina ranking eighth highest in the nation for the percentage of household income spent on health care.

According to a WalletHub study, North Carolinians spend an average of $895.49 annually on health care out-of-pocket, which accounts for 15.37% of the median monthly household income. This places North Carolina behind states like Mississippi and Louisiana, where residents spend over 17% of their income on health care.

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The study assessed costs across five key health care components: doctor visits, dentist visits, optometrist visits, and prices for common medications such as ibuprofen and Lipitor. North Carolina ranked 16th for doctor visit costs, 6th for dentist visits, and 15th for optometrist visits, reflecting relatively high prices in these categories.

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The rising health care expenses have tangible impacts on North Carolinians. The State Health Plan, which covers about 750,000 state employees and retirees, faces a projected $507 million deficit in 2026, potentially growing to $1.4 billion by 2027.

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This financial strain has led to increased premiums and out-of-pocket costs for members, including doubled copays for some specialist visits after the plan switched administrators from Blue Cross Blue Shield to Aetna.

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Many state workers report paying more for services that were previously lower cost or free, affecting their ability to afford care amid stagnant wages and inflation.

Experts attribute these high costs to several factors, including limited participation of providers in cost-containment programs and a wave of health care mergers that reduce competition.

Transparency in pricing is limited by trade secret protections, making it difficult for consumers to compare costs and make informed choices. State Treasurer Brad Briner advocates for a market-based system emphasizing price transparency and collaboration among payers and providers to address these challenges.

For residents, practical steps to manage health care expenses include:

  • Comparing prices for medical services when possible.
  • Utilizing generic medications as alternatives to brand-name drugs.
  • Engaging in preventive care to reduce the need for costly treatments.
  • Staying informed about changes in insurance plans and coverage.

Understanding the landscape of health care costs in North Carolina is crucial for making informed decisions and advocating for policies that improve affordability and access.

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