More health care price changes could be on the way in NC for state employees

The leaders of the State Health Plan met on Tuesday to debate whether to raise costs for North Carolina state employees who use certain health care providers.
Posted 3/18/2026, 6:39:00 PM Updated 3/18/2026, 7:25:44 PM

After a vote today big changes coming for how the

state health plan bills people

Some could pay less others might have to pay more

So here to break it all down is WRAL state

government reporter Will Doran

Will I want to get into the details here but

first we've got to talk about the stakes

Who is affected by these changes Yes Ashleigh more than

750,000 state government workers retirees their family members are insured

through the state health plan and right now it's facing

a big financial shortfall $200 million in the red this

year

The plan raised people's premiums last year

For the first time in nearly a decade but they

are also looking at other ways to get creative with

savings hoping that that helps avoid needing to raise rates

even higher

And that was really the debate today right How can

they save money on the health plan What was their

solution Actually they want to drive people away from certain

doctors hospitals other providers that charge a lot and instead

push people to doctors who agree to lower their rates

for state employees

Now the health can't force people to leave their doctors

but they can change how visits get billed

So going forward some providers will be completely free for

state health plan members

We're talking no co-pays no out of pocket costs even

for things like getting an X-ray or going to see

a specialist but at the same time the state is

going to hike up the costs to be treated by

other doctors who are not part of the state's group

of preferred providers

You reported that the state has already been sort of

testing this out

How is that going That's right

For the last few months certain kinds of surgeries have

been free for people on the state health plan a

sort of pilot program here but again it's using the

same model

It's only free if you go to the surgeon that

the state wants you to see

If you choose somebody else even if they are in-network

you could face higher bills

State health plan leaders say that program has gone so

well that they now want to apply the same rules

to

Basically all types of healthcare procedures

We are expecting another vote this summer to hammer out

all the details and these changes could be in effect

by next year

Free surgery

OK thanks Will

I know this is really complex but Will has an

article breaking this all down for you online at .com

I know you've worked hard on this one so that

you can learn more about this