Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has issued a warning about the growing challenges facing the health care system in the state. The organization’s CEO said that rising costs and instability are pushing the system toward a major shift.
According to Blue Cross NC, longstanding policy efforts have failed to control health care expenses, making it harder for people in North Carolina to afford coverage. A significant concern is the scheduled expiration of enhanced premium tax credits at the end of this year. The Centers for Medicare & Medicaid Services (CMS) estimates that nearly 919,000 individuals and families in North Carolina who purchase their own insurance could lose these subsidies. Without them, many may not be able to afford coverage and will turn to emergency rooms for care, increasing uncompensated care and putting additional pressure on hospitals and providers.
Another factor contributing to instability is recent volatility among insurers in the state marketplace. Since 2022, two health insurers have exited North Carolina’s Affordable Care Act (ACA) marketplace. Earlier this year, a national for-profit insurer announced it would stop covering individual plans in North Carolina starting January 1, 2026. This reduction in available options could lead to higher costs and more difficulty accessing care.
In response, Blue Cross NC outlined an action plan focused on collaboration and accountability within the industry. “We have a strong track record of partnership and collaboration, but we must go further. We will meet with any partner who shares our commitment to maintaining quality while lowering costs,” said the CEO of Blue Cross NC.
The company also committed to evaluating every decision based on its impact on member costs: “Second, for any action we contemplate, we’ll ask the question: Does this lower costs for members or raise them? We’ll hold ourselves and others accountable for any actions that add unnecessary strain on families and business.”
Efforts include investing resources into solutions that improve affordability and access; improving their website so members can find better prices on procedures or prescriptions; reducing administrative burdens for doctors; helping members with complex health needs through dedicated customer service advocates; and addressing youth mental health by working with community stakeholders.
“As the CEO of Blue Cross NC, I implore my colleagues across the health care industry to join us in acting now. Whether we like it or not, we’re out of time.The reckoning is here, and it will require unprecedented collaboration and cooperation across every sector,” said the CEO.
The company stressed its focus on serving members rather than shareholders by reinvesting resources into member benefits and community initiatives.
Blue Cross NC urged other organizations in the health care industry to commit to similar actions as part of a broader effort to address affordability, transparency, access issues, legislative challenges, and regulatory barriers affecting patients across North Carolina.
