Haywood County residents rethink health care coverage after premium increase
Fri, August 21, 2026 at 5:14 PM
UpdatedFri, August 21, 2026 at 5:36 PM
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FILE IMAGE – Signage for an emergency room in western North Carolina. (Photo: WLOS Staff)
HAYWOOD COUNTY, N.C. (WLOS) —Nearly nine months after marketplace health care plans increased in double digits, data show that Affordable Care Act enrollment in Haywood County has decreased
In 2025, the North Carolina Department of Insurance approved increases ranging from 16.88% to 36.4% for 2026 marketplace plans, depending on the insurer
As previously reported, as many as 9,000 Haywood County residents may have experienced an increase in health insurance this year, with over 5,000 of those individuals having insurance through the ACA’s Health Insurance Marketplace expected to see a sharp rise in premiums
PREMIUMS TO RISE IN 2026 FOR 700K+ NORTH CAROLINA RESIDENTS UNDER STATE HEALTH PLAN
Following the Jan. 15 enrollment deadline, new data from the Centers for Medicare and Medicaid Services shows that Haywood County enrollment in the ACA has declined from over 5,000 to 3,935 [seen in 37087]
US County Enrollment NumbersPDF preview
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But that decline is being seen across North Carolina
“Premiums have skyrocketed for many families, and nearly 165 thousand North Carolinians have already lost or dropped their ACA coverage entirely,” said Deborah Ross, U.S. Representative for NC 02, at a Defend American Action webinar
In February, as News 13 reported based on Centers for Medicare and Medicaid numbers, the state had 975,110 open enrollment participants in 2025. That number decreased in 2026 by nearly 22%, with open enrollment totaling 761,457
At the same webinar, Canton Mayor Zeb Smathers says that in an area such as Canton, which has experienced multiple severe weather events and the mill closure, it just adds to the stress
“This is an American issue, but for so many places in rural places like Canton, it’s on top of everything else we’re facing,” Smathers said.
NC RESIDENTS FACE STEEP HEALTH INSURANCE HIKES DURING OPEN ENROLLMENT
Jan Plummer, manager at Get Covered WNC at Mountain Projects, told News 13 through an email that the group is seeing residents rethink their coverage
“Most people are downgrading to a Bronze Plan even though they are eligible for a Silver with additional cost reductions,” said Jan Plummer, manager at Get Covered WNC at Mountain Projects
Plummer says this change in coverage ultimately increases out-of-pocket costs
“That means that people are paying higher out-of-pocket costs, including higher co-pays, higher deductibles, higher annual out-of-pocket maximum, even though their premium is lower; it doesn’t offset those additional costs,” Plummer said
Plummer says another thing Mountain Projects is seeing Haywood County residents do is look for Bronze plans with the lowest co-pay for medication and anything free with three free position visits
Ultimately, Plummer says that in the future, this could be detrimental to those who lost Medicaid because the cost of marketplace plans has increased, and those who have previously had Medicaid and were paying little to nothing will now be faced with the new increase
THOUSANDS OF HAYWOOD COUNTY RESIDENTS COULD SOON FACE HEALTH INSURANCE PREMIUM HIKES
“Someone who makes over 138% of the poverty level purchasing affordable plan on the marketplace can still $200, $300 a month for premium with a high deductible on the other end of the spectrum because of the elimination of the enhanced premium tax credits that allow people to earn up to 600% of the federal poverty level versus 400% that new cut off at 400%,” Plummer said
Plummer says the enhancement of premium tax credits has put people in higher income brackets without affordable options for plans
“They make too much money for Medicaid and they make too much money for tax credits, so we’re looking at plans that are $1,200, $1,500, even $2,100 for [a] household of two that are just over 400% a federal power level in those circumstances, those folks are looking at different options and health plans like short term indemnity types of plans,” Plummer said
Plummer says that as a result, residents are looking at direct primary care arrangements that involve paying cash, also seeing an impact on the management of Medicaid Plans offered as well as the marketplace plans
AFFORDABLE CARE ACT OPEN ENROLLMENT DECREASES NEARLY 22% IN NORTH CAROLINA
“We don’t have a large hospital system, and our community – we don’t have a mission or just a large hospital system that covers the western North Carolina area, so there’s really only one or two plans that offer enough providers in network, especially specialists, so that’s another thing complicating the situation,” Plummer said
Smathers says despite political views, this issue is affecting everyone
“This is affecting democrats, republicans, every race, every background, no matter who you voted for,” Smathers said
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