BUNCOMBE COUNTY, N.C.

As open enrollment for the Affordable Care Act kicks off, many residents in North Carolina are contending with significant premium hikes and a reduction in federal assistance that previously made insurance more affordable during the pandemic.

The North Carolina Department of Insurance has sanctioned premium increases for 2026 Marketplace plans, ranging from about 16.88% to 36.4%, based on the insurer.

According to Insurance Commissioner Mike Causey, these increases stem from escalating medical costs and the conclusion of enhanced federal subsidies that began in 2021.

“Rising healthcare costs and the end of federal subsidies are leading to increased premiums across numerous individual markets,” Causey mentioned in a statement on October 28.

Premium Hikes Expected as ACA Subsidies End

Open enrollment starts on November 1, with around 900,000 North Carolinians anticipated to sign up for 2026 coverage via HealthCare.gov before the January 15 deadline.

Doug Luck, an independent insurance agent from Arden, noted that clients are already feeling the impact. He highlighted that the typical silver-level plan has surged by $100 monthly for some individuals.

“Overall, it seems like most prices are creeping up a bit,” Luck shared. “One client had a silver plan that used to be around $111 a month, and it jumped to $262. Another moved from $120 to $320.”

Luck explained that the most significant changes are found in silver plans, which heavily depend on federal subsidies. As these funds are phased out, consumers are facing higher premiums.

“The base premium costs haven’t actually increased,” Luck remarked, “It’s more about who is paying—whether individuals are covering it themselves or relying on a subsidy.”

This shift might mean an increase of $150 to $200 monthly for many families seeking the same coverage. While most of Luck’s clients aim to retain their policies, some are contemplating dropping their insurance entirely.

Economic Strain Reflects in Health Insurance Costs

“Funds are scarce. Everything is getting more expensive, and realizing that health insurance costs are up $150 or $200 from last year is tough,” Luck stated.

He pointed out that this trend mirrors a wider issue: Healthcare expenses, including hospital care, prescriptions, and diagnostic tests, continue to rise, even as the federal subsidies that once offset these costs have faded away.

Luck advises individuals looking to purchase ACA coverage to act early, meticulously compare available plans, and ensure their income details are accurate to receive the right subsidy amount.

Plans chosen by December 15 will start on January 1, 2026, with open enrollment continuing until January 15.

For further details or to compare plans, visit healthcare.gov.