Rep. Ball files bill in North Carolina House to create statewide low-cost health plan

A new bill filed by State Rep. Cynthia Ball in the North Carolina House aims to expand affordable health coverage and improve transparency in hospital pricing and billing practices, according to the North Carolina State House.

The bill, filed as HB 1175 on April 30 during the 2025 regular session, was formally listed with the short title: ‘Affordability in Healthcare Act.’

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, this bill creates a statewide low-cost health plan on the ACA marketplace by 2028, caps its administrative costs, and ties premiums and cost sharing to affordability benchmarks. It forms a Public Health Purchasing Consortium to align public buyers and appropriates $25 million in recurring and $10 million in nonrecurring funds starting July 1, 2026, plus $175 million to continue and expand Healthy Opportunities Pilots for chronic disease prevention. The bill strengthens hospital price, quality, billing and facility fee transparency, guarantees good-faith cost estimates with tight overage limits, protects essential rural health services from destabilizing changes, updates prior-authorization rules including limits on AI-based denials, removes certificate-of-need review for inpatient rehabilitation, and tightly regulates major hospital consolidations and transactions.

Of the four sponsors of this bill, Maria Cervania proposed the most bills (45) during the 2025 regular session.

Bills in North Carolina follow a multi-step process before becoming law. A lawmaker starts by filing a bill, which is assigned to a committee for review. The bill must be read three times in each chamber. If one chamber changes the bill after the other passes it, both must agree on the final version. Once both chambers approve the same bill, it goes to the governor, who has 10 days (or 30 if the legislature is not in session) to sign, veto, or let it become law without a signature.

You can read more about the bills and other measures here.

Ball graduated from the University of North Carolina at Greensboro with a BA and again from Virginia Commonwealth University.

Ball, a Democrat, was elected to the North Carolina State House in 2017 to represent the state’s 49th House district, replacing previous state representative Gary Pendleton.