Raleigh -- July 1, 2026: Governor Josh Stein has signed Executive Order No. 39, creating the North Carolina Health Care Affordability Commission, a bipartisan panel charged with examining why health care costs continue to rise and recommending solutions to make care more affordable for families, employers, and taxpayers across the state.
The commission will be co-chaired by North Carolina Department of Health and Human Services Secretary Devdutta Sangvai and State Treasurer Brad Briner, bringing together leaders responsible for two of the state's largest health care programs. The Department of Health and Human Services oversees North Carolina's Medicaid program and public health initiatives, while the State Treasurer manages the State Health Plan, which provides health coverage to more than 750,000 teachers, state employees, retirees, and their dependents.
Governor Stein said rising health care costs have become a growing burden on North Carolina families and businesses. According to the Governor's Office, Americans now spend nearly $16,500 per person each year on health care, while average out-of-pocket medical expenses exceed $1,500 annually, not including insurance premiums. National health care spending has also continued to grow faster than inflation and wage growth, placing additional financial pressure on households.
Commission Will Study Health Care Costs Across North Carolina
The newly established commission will evaluate the factors contributing to rising health care costs and develop recommendations in several key areas, including:
Improving health care price transparency so patients can better understand the cost of services before receiving care.
Encouraging greater competition among health care providers to help reduce costs.
Addressing shortages of physicians, nurses, and other health care professionals, particularly in primary care.
Expanding access to quality primary care services.
Promoting value-based care models that reward better patient outcomes rather than the volume of services provided.
Developing strategies to improve affordability and access in North Carolina's rural communities.
The Executive Order also directs the commission to review prescription drug pricing, including data collected under North Carolina's SCRIPT Act, to better understand how medication costs affect consumers and the overall health care system.
Rural North Carolina a Major Focus
The commission's work is expected to have particular importance for rural areas of the state, including Western North Carolina, where many communities continue to face physician shortages, limited access to specialty care, and financial challenges affecting local hospitals.
The Executive Order specifically recognizes the unique challenges facing rural communities and calls for recommendations that improve both affordability and access to care outside North Carolina's urban centers.
Public Meetings and One-Year Mission
The commission will consist of seven voting members along with as many as 25 advisory members representing hospitals, physicians, insurers, employers, researchers, patient advocates, and other health care stakeholders.
Members will serve one-year terms, with the option of reappointment. The commission's meetings will be subject to North Carolina's Open Meetings Law, allowing the public and news media to observe its work and review meeting records.
Federal Changes Add New Challenges
The Executive Order notes that North Carolina's health care system is also facing uncertainty from changes at the federal level. State officials estimate that the expiration of enhanced Affordable Care Act premium tax credits could result in approximately 214,000 North Carolinians losing or not renewing Marketplace health insurance coverage. The order also warns that projected reductions in federal health care funding could have long-term financial impacts on hospitals and providers across the state.
While Executive Order No. 39 creates the commission, it does not immediately change insurance premiums, hospital pricing, or health care benefits.
Instead, the commission will spend the coming year gathering data, reviewing health care costs, consulting with experts, and developing recommendations for the Governor and the North Carolina General Assembly. Some recommendations may eventually require legislation, while others could be implemented through existing state agencies.
For North Carolina residents, the commission represents a statewide effort to address one of the fastest-growing financial pressures facing families, employers, and government alike. Its recommendations could influence future policies affecting insurance costs, hospital pricing, prescription drugs, workforce shortages, and access to care—particularly in rural communities across Western North Carolina.