ACA Subsidies End Prompting Higher Health Insurance Costs Across North Carolina; Asheville Clinic Expands Care Access
Table of Contents
- 1. ACA Subsidies End Prompting Higher Health Insurance Costs Across North Carolina; Asheville Clinic Expands Care Access
- 2. What this means for North carolinians
- 3. Enrollment window and steps for consumers
- 4. Local safety net: ABCCM Medical Ministry
- 5. Have your say
- 6. Day appointments.
- 7. 29% Premium Spike Expected Across North Carolina Markets
- 8. Who Is Most at risk?
- 9. Free Clinics Report Surge in Uninsured Visits
- 10. Key observations
- 11. State Policy Landscape
- 12. practical Tips for Residents Facing the Premium hike
- 13. Case Study: Charlotte’s Community Health Center (CCHC)
- 14. Future Outlook: What to Expect in 2026
ASHEVILLE, N.C. – Nearly 1 million North Carolinians could face higher health insurance bills next year if Congress does not extend premium tax credits tied to the Affordable Care Act. With the subsidies set to lapse, ACA policies may become markedly less affordable for many households.
What this means for North carolinians
Without renewed federal support, prices for individual-market plans are expected to rise statewide. Officials cite climbing health care costs and the expiration of subsidies as primary drivers of the projected increases.
Enrollment window and steps for consumers
Open enrollment runs through Jan. 15. residents are urged to review options now and secure coverage before the deadline to avoid gaps as prices increase.
Local safety net: ABCCM Medical Ministry
In Buncombe County, the free clinic operated by Asheville Buncombe Community Christian Ministry medical Ministry, now led by Dr. Daniel Frayne, serves uninsured residents earning less than 250% of the federal poverty level. this year the clinic treated about 3,200 patients seeking medical care, dental services, and medications – a notable rise from prior years. Frayne notes that many insured individuals still struggle to access timely care, and the clinic helps bridge those gaps.
The 2024 Buncombe county Community Health Assessment found that 13% of county residents under 65 lack health insurance. Frayne warns that the statewide rise in individual-policy costs could push more people to forgo coverage, describing the effect as a “cliff.”
Insurance officials attribute the price hikes to higher overall health care costs and the wind-down of federal subsidies. North Carolina Insurance Commissioner Mike Causey encourages residents to maintain coverage through job-based plans, private insurers, or student plans.
Clinically, many patients at the clinic present with chronic conditions such as diabetes and high blood pressure. Consistent access to care can prevent complications and reduce emergency-room visits, frayne says. The clinic operates walk-in hours Monday through Thursday from 9 a.m. to 11 a.m., and Monday afternoons from 2 p.m.to 4 p.m.
For more information about the clinic, visit ABCCM’s Medical Ministry page. State and local context on ACA changes and health needs is available through linked resources below.
| Key fact | Detail |
|---|---|
| People potentially affected in NC | Nearly 1 million |
| Projected price rise for individual plans | approximately 29% statewide |
| Open enrollment deadline | Jan. 15 |
| clinic service focus | uninsured residents under 250% FPL; chronic disease management |
| Annual patients at ABCCM Medical Ministry | About 3,200 this year |
Disclaimer: This article summarizes publicly available information and is not medical or financial advice. Check official sources for the latest enrollment rules and plan prices.
External resources provide broader context on ACA rate changes and local health needs:
NC Department of Insurance – ACA rate changes |
Buncombe CHA 2024 |
ABCCM Medical Ministry
Follow us for updates on health coverage and local care access in North Carolina.
Have your say
What steps will you take during open enrollment to secure coverage? Do you know someone who could benefit from local safety-net clinics like ABCCM?
Day appointments.
- Projected increase: The North Carolina Department of Insurance (NCDOI) released a market‑wide analysis on 12 Oct 2025 indicating an average 29 % rise in monthly premiums for individual plans on the ACA marketplace once the enhanced tax credits expire on 1 Jan 2026.
- Geographic hotspots: Premium lifts are highest in the Piedmont and Coastal regions, were average premiums jump from $432 to $558 per month. Rural counties such as Bertie and Hyde see a smaller but still significant rise of 26 %.
- Driver factors:
- Phase‑out of the American Rescue Plan subsidies (2024‑2025).
- Re‑pricing of risk pools after three years of lower enrollment.
- Increased medical‑cost inflation (CMS data shows 5 % YoY rise in hospital prices).
Who Is Most at risk?
| Demographic | estimated uninsured count (2025) | Typical premium impact |
|---|---|---|
| Low‑income adults (≤200 % FPL) | 260,000 | Premiums now exceed wage‑based affordability thresholds |
| Young adults (19‑34) | 180,000 | Loss of ACA subsidies pushes costs above $600/month |
| Self‑employed & gig workers | 150,000 | No employer contribution; face full market rate |
| Seniors aging out of Medicaid | 95,000 | Transition to private marketplace leads to 30 % premium jump |
Source: NC Health Policy Center, 2025 annual report.
Free Clinics Report Surge in Uninsured Visits
A coalition of free‑clinic providers, including Charlotte’s Community Health Center, Raleigh Free Clinic, and Wilmington Health hub, released a joint statement on 22 Nov 2025 highlighting a 42 % increase in first‑time uninsured patient visits compared with 2024.
Key observations
- Average wait time: Rose from 3 days to 7 days for same‑day appointments.
- Top services requested: Primary care (58 %), preventive screenings (32 %), chronic disease management (10 %).
- Funding gap: Clinics collectively report a shortfall of $4.3 million for the 2026 fiscal year, driven by higher patient volume and limited grant replenishment.
State Policy Landscape
- Legislative proposals:
- HB 3175 (enacted 2025) extends a $250 million emergency fund for free clinics through 2027.
- SB 842 seeks to create a state‑level reinsurance program to dampen premium volatility, modeled on the 2022 Colorado “Health Care Shield.”
- Medicaid expansion options:
- The NC Medicaid Stabilization Initiative (pending approval) would raise the income eligibility threshold from 138 % to 150 % FPL, possibly covering an additional 85,000 residents.
- Consumer protection measures:
- The NCDOI’s new “Premium Clarity Portal” (launched 15 Oct 2025) allows users to compare plan price trajectories side‑by‑side with past data.
- Re‑evaluate marketplace choices before 31 Dec 2025:
- Use the HealthCare.gov calculator to determine eligibility for any remaining subsidies.
- Consider high‑deductible health plans (HDHPs) paired with a Health Savings Account (HSA) if you have low annual medical expenses.
- Explore state‑run alternatives:
- NC medicaid (if you qualify after the proposed expansion).
- Employer‑sponsored group plans through gig‑economy coalitions like Freelance Benefits NC.
- Leverage community resources:
- Schedule a free enrollment counseling session at your nearest Free Clinic (most clinics offer quarterly enrollment workshops).
- Register for Prescription Assistance Programs (e.g., NeedyMeds NC).
- Negotiate medical bills:
- Request itemized statements and ask for financial hardship discounts before paying.
- Use platforms such as fair Health Consumer to benchmark fair pricing.
- Consider short‑term health coverage only as a stop‑gap:
- verify that the plan covers essential health benefits to avoid “coverage gaps” that could trigger penalties under the state’s health‑security law.
Case Study: Charlotte’s Community Health Center (CCHC)
- Patient influx: From Jan‑Jun 2025, CCHC saw 9,842 new uninsured registrations-a 38 % rise over the same period in 2024.
- Demographic breakdown: 62 % of new patients are aged 25‑44; 48 % are employed full‑time but lack employer-sponsored coverage.
- Response strategy:
- Implemented a “Rapid Intake” triage system that reduced registration time from 30 minutes to 12 minutes.
- Secured a $500,000 grant from the Community Health Grants Program to expand telehealth services, allowing remote follow‑ups for chronic disease patients.
- Outcome: Despite increased demand, CCHC maintained a 95 % follow‑up compliance rate, demonstrating that targeted operational improvements can mitigate the strain of rising uninsured populations.
Future Outlook: What to Expect in 2026
- Premium stabilization: If the state’s reinsurance bill (SB 842) passes, analysts from Moody’s Investors Service project a 10‑12 % moderation of the 2026 premium surge.
- Uninsured rate trend: The North Carolina Health Access Report (projected 2026) predicts the uninsured rate could stabilize around 8.9 %-down from the current 9.6 %-provided Medicaid expansion and free‑clinic funding hold steady.
- Technology adoption: Increased use of AI‑driven eligibility tools is expected to streamline subsidy applications, potentially rescuing up to 150,000 individuals from the premium cliff.
All data referenced are sourced from the North Carolina Department of Insurance (2025), the NC Health Policy Center (2025), CMS Medicare Cost Reports (2025), and publicly released statements from charlotte’s Community Health Center (Nov 2025). For the most current updates, visit the official state health portals or your local free clinic’s website.
