We recently told you how rising healthcare costs are forcing employers to make tough choices — smaller raises, reduced benefits, and higher out-of-pocket costs for workers. With a family health plan now averaging nearly $27,000 a year, those pressures are only growing.
Business leaders across North Carolina are taking notice – and they’re calling for action to make healthcare more affordable.
Greg Thompson, North Carolina State Director, National Federation of Independent Businesses:
“I’ve worked with small and independent businesses across North Carolina for over 20 years, and in all that time, I’ve heard the same concern from our members: Health insurance costs are out of control…
“There’s no single solution, but there are clear steps we can take:
"Stop piling on new mandates. Every new health care mandate drives up insurance costs for small businesses. In 2025 alone, eight new ones were introduced. Enough is enough.
"Increase competition. Eliminating outdated Certificate of Need laws that drive up costs is a good place to start. Competition lowers costs and raises quality in every other part of the economy. Health care should be no different.
"End hidden fees. Patients should never be stuck with a hospital “facility fee” for something like a routine checkup or a child’s doctor visit outside a hospital. These fees add millions in unnecessary costs every year.”
Tunde Sotunde, President and CEO, Blue Cross Blue Shield North Carolina:
“Rising health care costs are a strain on business…if the price of common household purchases increased at the same rate as health care over the last 60 years, here’s what you’d pay today:
"$18.94 for a gallon of gas;
"$230,000 for a midsize car; and
"$1.3M average cost for a single-family home.
“In North Carolina, there are so many reasons pushing the cost of health care up…
“Even within the same town, a person can receive a bill at one facility, visit a different facility on the other side of town and the cost can vary significantly, often without a clear reason. This makes it hard for consumers to shop for affordable care.”
Aubie Knight, CEO, Independent Insurance Agents of North Carolina:
“North Carolina is now among the most expensive states in the country for health care. Costs are growing at an unsustainable pace, and there’s no sign they will slow on their own. If we want to keep health insurance within reach for working families, we have to take action to bring those costs down…
“First, families pay more when the health care systems limit competition. Hospital noncompete agreements with physicians give large systems too much control over the workforce. This blocks new providers from entering the market and makes it harder for lower-cost options like urgent care and ambulatory surgical centers to open. When hospitals don’t have to compete, prices go up — and patients feel it in their premiums.
“Second, we must rein in unnecessary and hidden hospital fees. Too often, patients are charged a “facility fee” for routine care — even if they never set foot in a hospital. These fees add millions in unnecessary costs on top of what patients already pay.
“Third, we need to lower the price of prescription drugs. Families shouldn’t have to choose between paying for medicine and paying their bills.”
Across the state, leaders from the business community are saying the same thing: healthcare costs are unsustainable, and reform can’t wait.
It’s easy to feel like the problem is too big to fix. But as these leaders make clear, there’s a full menu of solutions on the table — ending facility fees, reforming outdated mandates, ending markups on prescription drugs, promoting competition, and pushing for site-neutral payments.
For a state that’s No. 1 for business but near the bottom for healthcare affordability, the best approach isn’t one idea or another — it’s all of the above.
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