North Carolina House Majority Leader Brenden Jones is voicing opposition to the upcoming changes within the State Health Plan. Starting in January, the plan will implement a tiered provider network that assigns hospital systems as either preferred or non-preferred. Under this new model, members who receive care at non-preferred hospitals will face higher out-of-pocket costs.
The State Health Plan designated systems like UNC Health and Novant Health as preferred providers. In contrast, hospitals such as WakeMed, Atrium Health, and Granville Health System fall into the non-preferred category. Duke Health will serve as an access provider, meaning member costs will remain stable. State officials maintain that this restructuring is a necessary step to address long-term financial deficits and stabilize the plan.
Rep. Jones argues that the shift disproportionately harms residents in rural communities. In a letter shared on social media, he noted that the policy forces patients to choose between paying increased costs or traveling long distances to reach preferred providers. He expressed concern that this could disrupt established care relationships and pressure independent rural hospitals to consolidate or reduce services.
Leadership within the House, including Speaker Destin Hall, acknowledges the need for financial stability but has raised questions about the policy’s impact on patient access. Spokespeople for the House confirmed that discussions are ongoing between the State Health Plan and affected entities like Atrium Health. Officials involved with the plan stated they are reviewing options to reach a viable solution before the January deadline.