North Carolina HB 1175: 2020 Safe Drinking Water Act.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 1175

Short Title: Affordability in Healthcare Act. (Public)
Sponsors: Representatives Cervania, Crawford, Ball, and Belk (Primary Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Rules, Calendar, and Operations of the House
May 4, 2026
*H1175-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO LOWER HEALTHCARE COSTS, INCREASE COMPETITION IN THE 2
HEALTH INSURANCE MARKET, AND IMPROVE VALUE AND TRANSPARENCY 3
BY LEVERAGING THE STATE'S PURCHASING POWER; TO ESTABLISH A 4
LOW-COST, AFFORDABLE HEALTH PLAN OPTION ON THE AFFORDABLE CARE 5
ACT HEALTH INSURANCE MARKETPLACE; TO CREATE A HEALTHCARE 6
PURCHASING CONSORTIUM TO ALIGN PUBLIC PROCUREMENT; TO 7
APPROPRIATE FUNDS FOR IMPLEMENTATION; TO CONTINUE AND EXPAND 8
HEALTHY OPPORTUNITIES ACTIVITIES TO PROMOTE CHRONIC DISEASE 9
PREVENTION; TO ELIMINATE CERTIFICATE OF NEED REVIEW FOR INPATIENT 10
REHABILITATION SERVICES, REHABILITATION FACILITIES, AND 11
REHABILITATION BEDS; TO PROVIDE GREATER PROTECTION FOR ESSENTIAL 12
RURAL HEALTH SERVICES; AND TO PRESERVE COMPETITION IN HEALTHCARE 13
BY REGULATING THE CONSOLIDATION AND CONVEYANCE OF HOSPITALS. 14
Whereas, the people of North Carolina are entitled to timely, affordable, and 15
high-quality healthcare as a matter of human dignity, public welfare, and fundamental fairness; 16
and 17
Whereas, healthcare is not a luxury but a necessity, and the inability to obtain needed 18
care or coverage endangers the lives, well-being, and economic security of individuals, families, 19
and communities across this State; and 20
Whereas, in 2026, the cost of healthcare in North Carolina remains too high for too 21
many residents, employers, and taxpayers, driven in part by market consolidation, opaque 22
pricing, administrative burdens, avoidable chronic disease, barriers to meaningful competition, 23
and billing and facility practices that increase costs without commensurate improvement in 24
patient outcomes or access to care; and 25
Whereas, excessive healthcare costs force North Carolinians to delay treatment, forgo 26
preventive care, accumulate medical debt, and remain uninsured or underinsured, thereby 27
worsening illness, increasing long-term system costs, and deepening inequality; and 28
Whereas, high healthcare prices also impose substantial burdens on small businesses, 29
local governments, North Carolina State Health Plan for Teachers and State Employees, and 30
other public purchasers, diverting resources away from wages, education, infrastructure, and 31
other public needs; and 32
Whereas, many North Carolinians remain uninsured or lack access to coverage they 33
can reasonably afford, and the State has a compelling interest in expanding access to dependable, 34

General Assembly Of North Carolina Session 2025
Page 2 House Bill 1175-First Edition
affordable health benefit plans so that residents may obtain needed care before medical 1
conditions become more severe and more costly; and 2
Whereas, chronic disease is a major driver of suffering, preventable death, and rising 3
medical expenditures, and public health initiatives that prevent, mitigate, and better manage 4
chronic illness are necessary both to improve quality of life and to reduce long-term healthcare 5
costs; and 6
Whereas, consumers and patients should be protected from healthcare practices that 7
increase prices, obscure the true cost of care, delay or complicate treatment, or impose charges 8
unrelated to improvements in quality, safety, or clinical outcomes; and 9
Whereas, it is in the interest of the State to lower healthcare costs by increasing 10
competition, leveraging public purchasing power, expanding access to affordable coverage, 11
encouraging public health strategies that reduce chronic disease, and protecting patients and 12
consumers from practices that inflate costs without improving care; Now, therefore, 13
The General Assembly of North Carolina enacts: 14
15
PART I. INCREASING COMPETITION AND LOWERING HEALTHCARE COSTS 16
THROUGH MARKETPLACE INNOVATION AND PURCHASING ALIGNMENT 17
SECTION 1.1.(a) The General Assembly finds that rising healthcare costs continue 18
to place significant financial strain on individuals, families, employers, and taxpayers across 19
North Carolina. It is in the public interest to promote affordability, expand consumer choice, 20
improve transparency, and strengthen health outcomes by increasing competition in the 21
individual health insurance market and leveraging the State's purchasing power more effectively. 22
The General Assembly further finds all of the following: 23
(1) In many regions of North Carolina, limited competition in the individual 24
health insurance market contributes to higher premiums and fewer affordable 25
coverage options for consumers. Establishing a lower-cost, State-supported 26
health plan option offered on the Affordable Care Act Health Insurance 27
Marketplace can increase