As independent insurance agents, my members are among those on the front lines of the health care system. Every day, we sit across the table from families, small business owners, and employees trying to make sense of their health plan options. We see the impact of increasingly unaffordable premiums firsthand.
This year, premiums may rise even faster than in years past, as federal health insurance subsidies are set to expire at the end of the year. It’s a part of the mess in Washington right now, part of the reason for the federal government shutdown.
But even if Congress acts to extend those subsidies, it won’t solve the fundamental problem. Subsidies are a patch on the underlying problem — the high cost of care.
Bringing down the cost of care itself is the only way to bring down premiums and lower government spending on health care.
When premiums go up, people often blame the insurance company or their agent. But here’s the truth: premiums are simply a reflection of the cost of care.
Every month, premiums from policyholders go into one big pot. That money pays the claims for everyone in the plan — doctor visits, hospital stays, prescription drugs, and more. If the total cost of care goes up, premiums have to go up too. There’s no way around it.
That’s why North Carolina families are struggling. Health care itself is too expensive. And unless we lower those costs, premiums will keep climbing.
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.
So how do we get there?
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.
Independent insurance agents want North Carolina families to have access to affordable, high-quality care. But as long as the cost of care keeps rising unchecked, we’ll continue to see premiums climb year after year.
It’s time for lawmakers to tackle the root of the problem. If we can make health care more affordable, insurance will follow. And that’s a win for every North Carolina family.
