Does NC have the 5th highest health insurance premiums?


Americans spend more on health care than comparable countries, according to a recent analysis.

So it’s probably no surprise that the Pew Research Center found health care to be a top concern of voters, or that North Carolina politicians are talking about it ahead of the midterms.

This November, Democrats hope to break the Republican supermajority in the state legislature. Among them is D. Cole Phelps, an attorney running for state Senate in northeastern North Carolina’s District 1 against Republican state Rep. Bob Steinburg.

On Labor Day, Phelps claimed in a Facebook post that health care premiums in North Carolina are among the most expensive in the country.

“Health care premiums in North Carolina are now among the five highest states in the country — and rural health care is struggling,” Phelps posted on Sept. 1. “Our opponent is protecting insurance company profits — not his constituents. As your state senator, I will fight for every person in Senate District One, including people with pre-existing conditions.”

Are health insurance premiums in North Carolina higher than those in 45 other states? PolitiFact reached out to Phelps for the source of his information.

To support his claim, Phelps cited a recent WalletHub story, “The Best and Worst States for Healthcare.” WalletHub, which looked at all 50 states and Washington, D.C., ranked North Carolina’s health care system 47th for overall care. The Tar Heel State ranked 45th for average monthly insurance premiums.

But there’s a key piece of information that’s buried in the WalletHub story and that Phelps doesn’t mention in his Facebook post: WalletHub only looked at health care plans through the Affordable Care Act, also known as Obamacare.

It didn’t take into account premiums for insurance plans acquired through employers.

More than 55 percent of Americans have employer-based health insurance plans, according to 2016 estimates by the U.S. Census Bureau. In North Carolina, employer-based plans covered 52 percent of all non-Medicare recipients during 2016, according to an analysis by the Kaiser Family Foundation, a nonprofit health analysis organization.

So, with that in mind, we wondered whether North Carolinians are paying some of the highest premiums for health insurance plans across the board. Here’s what we found for both customers in the ACA markets as well as on employer-sponsored plans.

True, for ACA premiums

When it comes to premiums for people with plans through the Affordable Care Act, Kaiser found that North Carolina had the seventh-highest average benchmark premiums in 2018. In 2017, NC had the second-highest. More than 478,000 people enrolled in such plans in 2018, KFF reports.

However, the average benchmark isn’t an accurate reflection of what most customers pay, said Craig Palosky, KFF communications director.

Though the benchmark shows the full sticker price, it’s “not what people who get tax credits would end up paying,” Palosky said. ” The distinction is important because the vast majority of marketplace customers do get tax credits – 87 percent nationally and 94 percent in North Carolina.”

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