Without extended tax credits, health insurance premiums are expected to increase by more than $13,000 annually for a family of four making $130,000 a year. (izzuan/Adobe Stock)
Health insurance costs are set to rise in 2026 for many North Carolinians, after Congress decided not to vote on extending Affordable Care Act insurance tax credits, which were cut in the One Big Beautiful Bill Act and expire at the end of the year.
Without the credits, nearly 1 million people in North Carolina will see their monthly health care costs rise 149% on average.
Rep. Alma Adams, D-N.C., spoke about the impact from cuts while pushing for a vote on extending tax credits.
“Not only does their bill fail to extend the ACA tax credits — something that helps 88,000 folks in my district afford health insurance — it abandons financial assistance for middle-class families,” Adams contended. “I mean, they’re already struggling to make ends meet.”
About 36,000 North Carolinians are expected to lose their health care because of the increase in health care premiums. Some will be hit harder than others after the Affordable Care Act tax credits expire. For example, a 60-year-old couple in the state making $85,000 will be the among the hardest hit, with an expected premium increase of $25,000 per year. Republicans in Congress said an extension of health insurance tax credits would not fix the underlying problems of the Affordable Care Act.
Instead, House Republicans have introduced their own plan expanding the availability of low-cost, low-coverage insurance, creating transparency requirements on pharmacy benefit managers and funding for certain kinds of cost-sharing reductions to premiums. The plan does not extend the Affordable Care Act subsidies.
Vaishu Jawahar, director of policy programs for the advocacy group Protect Our Care, said it would erase progress made by the Affordable Care Act.
“The ACA has helped us reach our highest level of coverage in our country,” Jawahar pointed out. “In 2024, only 8% of Americans were uninsured, and that was because these tax credits were expanded and extended.”
She added without subsidies, it could be harder for people to afford health insurance if they have preexisting conditions, as well as making it harder for people to afford care for chronic conditions. The House GOP plan passed without an extension but the bill is unlikely to pass in the Senate.
Related: NC resident faces 1,100% increase in health insurance costs
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