North Carolina SB 24: Govt Mandates Increase Healthcare Costs.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 2
SENATE BILL 24
Second Edition Engrossed 2/12/25

Short Title: Govt Mandates Increase Healthcare Costs. (Public)
Sponsors: Senators Burgin, Galey, and Sawrey (Primary Sponsors).
Referred to: Rules and Operations of the Senate
January 30, 2025
*S24-v-2*
A BILL TO BE ENTITLED 1
AN ACT TO DISCLOSE THE COST OF STATE GOVERNMENT HEALTH INSURANCE 2
MANDATES ON NORTH CAROLINA'S EMPLOYERS AND TAXPAYERS. 3
Whereas, the rising healthcare costs in North Carolina place a significant financial 4
burden on individuals, families, employers, and taxpayers, greatly contribute to inflation, and 5
make it increasingly difficult for residents to access essential healthcare services; and 6
Whereas, North Carolina has intolerably high healthcare costs, with recent studies 7
ranking the state 50th out of 50 in the United States; and 8
Whereas, government-mandated health insurance requirements for employers in 9
North Carolina lead to higher premiums, placing undue financial strain on employers, 10
particularly small businesses; and 11
Whereas, health insurance mandates on the North Carolina State Health Plan for 12
Teachers and State Employees carry a cost that is ultimately paid for by taxpayers and divert 13
resources away from other critical public services and economic investments; and 14
Whereas, many consumers in North Carolina are forced to pay for health insurance 15
coverage they neither need nor use as a result of government-mandated benefits that do not align 16
with their personal healthcare needs or preference; and 17
Whereas, the continued escalation of healthcare costs driven by government mandates 18
exacerbates the rising cost of living, as individuals and families struggle to afford both premiums 19
and out-of-pocket expenses for necessary care, and the rising cost of doing business, as employers 20
struggle to continue offering health insurance to employees; Now, therefore, 21
The General Assembly of North Carolina enacts: 22
23
PART I. HEALTH BENEFIT MANDATE LEGISLATION 24
SECTION 1. Article 31 of Chapter 120 of the General Statutes is amended by adding 25
a new section to read: 26
"§ 120-272. Legislation containing health benefit mandates. 27
(a) Definitions. – The following definitions apply in this section: 28
(1) Health benefit mandate. – A regulation impacting a health benefit plan or the 29
State Health Plan that meets any of the following criteria: 30
a. Mandates that a health benefit plan or the State Health Plan provide 31
coverage of any healthcare service, any specific treatment or set of 32
treatments, or any prescription drug used for the treatment of any 33
health, physical, mental, or behavioral condition. 34
b. Requires that a health benefit plan or the State Health Plan include 35
coverage for any healthcare service or treatment by a provider or group 36

General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 24-Second Edition
of providers other than an individual licensed under Article 1 of 1
Chapter 90, Article 4A of Chapter 90, or Article 9A of Chapter 90 of 2
the General Statutes. 3
c. Places requirements on any cost-sharing mechanism utilized by a 4
health benefit plan or the State Health Plan, such as a copayment or 5
deductible. 6
d. Regulates any health benefit plan or the State Health Plan cost-control 7
process, including those that necessitate a healthcare provider obtain 8
advance approval from an insurer before a specific service, treatment, 9
or prescription benefit is delivered to the patient or utilized by the 10
patient in order to qualify for coverage under the applicable plan. 11
e. Places a limit or requirement on a pharmacy benefits manager under 12
Article 56A of Chapter 58 of the General Statutes. 13
f. Regulates the manner in which a health benefit plan or the State Health 14
Plan provides coverage for a healthcare service, treatment, or 15
prescription drug, regardless of whether the regulation is imposed 16
upon a covered service that is provided by a healthcare provider that 17
participates in the provider network of the health benefit plan. 18
(2) Health benefit plan. – As defined in G.S. 58-3-167. 19
(3) Piece of legislation. – Any introduced bill, any bill or proposed committee 20
substitute considered by a committee, or any bill, conference committee 21
report, or proposed conference committee substitute considered by either 22
chamber of the General Assembly. 23
(4) State Health Plan. – The North Carolina State Health Plan for Teachers and 24
State Employees. 25
(b) Required Additional Statutory Repeals. – Any piece of legislation containing one or 26
more new health benefit mandates is required to also contain at least one provision that repeals 27
at least the same number of health benefit mandates that are already in effect as of the date of the 28
consideration of that piece of legislation prior to ratification of that legislation. 29
(c) Appropriation Required. – Any piece of legislation containi