Why is healthcare so expensive? A bipartisan NC group will tackle rising costs

A new bipartisan advisory board in North Carolina established by the Democratic governor will take a look at why healthcare is so expensive — and getting even more so.

Gov. Josh Stein signed an executive order Tuesday that establishes the “Health Care Affordability Commission,” which will be made up of healthcare experts from across the industry, including medical providers, hospitals, insurers, researchers, patients and advocates. It will also include lawmakers from both sides of the aisle.

Before signing the order, Stein said he recently heard from a Johnston County doctor who told him about an elderly couple who both had chronic disease. They kept coming back to the emergency room month after month. Eventually, the doctor learned they were not able to afford the cost of medication to manage both of their chronic diseases at the same time, so they traded off whose week it was to buy medication. And that was despite both having worked all their life and having Medicare.

“Our healthcare system is failing,” Stein said.

“How many North Carolinians are like this couple, facing impossible decisions every month?” Stein said. “How many families are pushing back the medical bills that they can’t afford, or wondering whether that essential procedure is truly essential? How many people have checked their bank account balance while waiting in a doctor’s waiting room?”

Stein made the announcement at Advance Community Health in Raleigh, a community health center that serves patients regardless of their ability to pay or insurance status, alongside North Carolina Department of Health and Human Services Secretary Dev Sangvai and State Treasurer Brad Briner. Sangvai and Briner are co-chairs of the new commission.

Briner, a Republican, oversees the State Health Plan, which covers hundreds of thousands of state employees and has faced rising costs, while Sangvai leads DHHS, which is tasked with administering Medicaid, the insurance program for low-income North Carolinians, and various health services across the state.

Stein said he was creating the commission to tackle ever-rising healthcare costs and that it “will get to work quickly to align on a bold set of solutions.” He said that would be done by relying on the expertise of the group and by looking at data, other states, and the unique factors impacting North Carolina. They’ll look at how to improve competition, enhance price transparency, rein in rising drug costs, among other things.

The United States spends far more per person on health care than other high-income countries, according to a 2026 analysis by the Peterson-KFF Health System Tracker. The U.S. spends $14,775 per capita, nearly double the average among peer countries is $7,860. A Commonwealth Fund analysis also found that Americans are more likely than residents of peer nations to avoid care because of cost, and to face more preventable deaths. The analysis calls the U.S an outlier because it lacks universal health coverage — one of only two countries in a 20-nation study, alongside Mexico, that have not achieved it.

The same analysis projected that recent federal cuts to Medicaid, which covers lower-income residents, and the expiration of enhanced Affordable Care Act Marketplace subsidies could leave an additional 17 million Americans uninsured by 2034. About 27 million Americans, or about 8% of the population, are currently uninsured.

A nationwide Forbes Advisor study found that North Carolina is the most expensive state in the nation for healthcare.

In North Carolina, lawmakers recently passed a bill providing additional funding for Medicaid to keep the program running through the end of June. And a budget for the fiscal year that begins July 1 was released on Tuesday. About $1 billion in Medicaid funding is included in it, according to news releases by Republican leaders. Preventing misuse and avoiding excess spending have also been a focus of Republican legislators; they included funding for 12 new positions within the NC Medicaid Office of Compliance and Program Integrity, which works to stop fraud, waste, and abuse.

Briner said on Tuesday at the event that he wanted to “applaud our Republican leaders in the legislature. They have shown the initiative in the budget, which is about to release, to keep health care affordable for our members.”

He said that budget includes a “significant increase in funding,” or about $4 billion, for the State Health Plan. He said if they had not provided that funding, the premiums for those on the plan would have risen by a further $38 per member per month.

“The commission is an opportunity to bring people together with a shared understanding and develop recommendations that can make a meaningful difference (for) our state,” Sangvai said.

Voting members of the commission are Briner and Sangvai, as well as several lawmakers involved in healthcare legislation: Sen. Gale Adcock, a Cary Democrat; Rep. Allen Buansi, a Chapel Hill Democrat; Sen. Benton Sawrey, a Clayton Republican; and Rep. Timothy Reeder, an Ayden Republican. Kristin Walker, director of the Office of State Budget and Management, will also serve as a voting member. There are also numerous advisory members.

Asked about how there have been several study groups across the years and whether this one would have the ability to push back against interest groups, Sangvai said, “everybody’s being impacted by this (costs). The hospitals are being impacted by it, providers are being impacted by it.”

What is different now is “the urgency. Historically, we’ve been talking about double-digit premium increases over the course of three to five years, or what’s going to happen a decade from now, we’re starting to see real significant change as a result of premium increases, coverage loss, and so forth,” Sangvai said.

Reeder, who was present during the event on Tuesday, added that “we have to be optimistic that we will find a solution, even though many haven’t before us.”

This story was originally published June 30, 2026 at 11:21 AM.

Luciana Perez Uribe Guinassi

The News & Observer

Luciana Perez Uribe Guinassi is a politics reporter for the News & Observer. She reports on health care, including mental health and Medicaid expansion, hurricane recovery efforts and lobbying. Luciana previously worked as a Roy W. Howard Fellow at Searchlight New Mexico, an investigative news organization.