NC Health Insurance Open Enrollment 2027: Premiums Rise for Charlotte and Raleigh Families

Open enrollment for 2027 health coverage starts today, November 1. If you buy your own insurance in North Carolina, from Charlotte to Raleigh, expect higher prices and a lot of plans to sort through.

What changed for 2027

The North Carolina Department of Insurance released approved 2027 rates on October 30. For individual ACA plans, premiums are going up between 8.35% and 27.36%, depending on the plan. Small group plans, which many small businesses buy, are going up between 18.78% and 19.54%, the department said.

Insurance Commissioner Mike Causey said the increases are "way less than last year's," but that "the increased cost of claims, healthcare and prescription drugs continues pushing monthly premiums higher."

Key dates

• December 15: Sign up by this date for coverage that starts January 1.
• January 15: Open enrollment ends. Coverage for people who sign up after December 15 starts February 1.

Dates are from HealthCare.gov. The state also has free help from consumer specialists at 855-408-1212, weekdays from 8 a.m. to 5 p.m.

What it costs families

For a family paying its own premium, a double-digit increase can mean hundreds or thousands of dollars more next year. Tax credits lower the price for many people, so your final cost depends on your income and household size.

Then there is the work of choosing. According to a CMS fact sheet released October 30, HealthCare.gov shoppers will have about 100 plans to choose from on average, from five or six insurance companies. More choice can be good. But when each plan sets up its deductibles, copays and networks a little differently, it is hard to tell which one is really the best deal for your family.

And the surprises do not end at sign-up. After a hospital visit, many families still get separate bills from the hospital, the anesthesiologist, the lab and others, each with its own network rules.

How Idea 5 would help

Idea 5, Send One Hospital Bill and Make Insurance Easier to Compare, goes after both problems.

• Plans you can compare side by side. A limited set of standard plan designs, so you can see the real differences in benefits at a glance.
• Common billing codes and clear payment schedules. Insurers could not win by making claims harder to understand.
• One network answer. A provider that accepts a plan would accept it at all its locations.
• One hospital bill. For care the hospital arranges, you would get one bill, and the hospital would pay the other providers.
• Accountability for nonprofit hospitals. They would publish how much free and discounted care they give and how they use their tax exemption.

There are tradeoffs. Standard plans can limit new ideas, and some doctors might leave insurance networks and take only cash. This is a draft idea, not current law.

Tell us what you think

Would standard, easy-to-compare plans and one hospital bill make open enrollment less painful for your family? Vote yes, no or not sure on Idea 5, and add a private comment if you like.

If issues like this make you think about public service, our Run for Office page shows how to get started.

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