Gregg Thompson, state director of the National Federation of Independent Business (NFIB) in North Carolina, has called on the state’s General Assembly to address rising health insurance costs in its next legislative session.
Thompson, who has worked with small and independent businesses across North Carolina for over two decades, said health insurance costs remain a top concern among NFIB members. “Health insurance costs are out of control,” he wrote.
He noted that while North Carolina is recognized as the top state for business due to effective policies and entrepreneurial efforts, it lags behind in health care affordability. “That’s a hidden tax on every small business owner in our state. And if we don’t get serious about fixing it, we won’t hold onto our top ranking for long,” Thompson said.
Rising premiums are affecting not only small businesses but also large employers and individual workers. According to Thompson, employees are experiencing higher paycheck deductions and increased medical bills or smaller raises as a result. He cited a national survey of more than 700 employers indicating that nearly half plan to increase employee cost-sharing in 2025, with more than half expecting to do so in 2026. Thompson added that North Carolina faces even greater challenges than the national average.
Thompson outlined several steps he believes could help lower health care costs:
“Stop piling on new mandates. Every new health care mandate drives up insurance costs for small businesses. In 2025 alone, eight new ones were introduced. Enough is enough.”
“Increase competition. Eliminating outdated Certificate of Need laws that drive up costs is a good place to start. Competition lowers costs and raises quality in every other part of the economy. Health care should be no different.”
“End hidden fees. Patients should never be stuck with a hospital ‘facility fee’ for something like a routine checkup or a child’s doctor visit outside a hospital. These fees add millions in unnecessary costs every year.”
Thompson stated that when lawmakers return to Raleigh next spring, NFIB will remind them that small business owners want to provide affordable health insurance for their employees and families but face mounting financial challenges.
“If costs keep climbing, business owners will be forced into tough decisions that hurt workers and weaken our economy. That’s not the future any of us want,” he said.
He concluded by urging policymakers to make North Carolina not only No. 1 for business but also No. 1 for affordable health care.
