North Carolina House bill proposes statewide affordable health plan, aims to increase hospital pricing transparency

State Rep. Cynthia Ball has introduced legislation in the North Carolina House intended to broaden affordable health insurance options and boost transparency in hospital billing and pricing, according to the North Carolina State House.

Filed as HB 1175 on April 30 in the 2025 regular session, the bill carries the short title: ‘Affordability in Healthcare Act.’

Here is an overview, reflecting details from the actual bill text, along with clarification of key provisions.

The legislation would establish a statewide affordable health plan on the ACA marketplace by 2028, set limits for administrative costs, and link premiums and cost sharing to affordability standards. It would create a Public Health Purchasing Consortium, appropriate $25 million in recurring and $10 million in nonrecurring funds as of July 1, 2026, and allocate $175 million for the Healthy Opportunities Pilots focusing on chronic disease prevention. The bill seeks to reinforce transparency for hospital price, quality, and billing, require clear cost estimates with strict limits on unexpected charges, safeguard core rural health services from disruptions, revise prior-authorization policy to restrict AI-driven denials, eliminate certificate-of-need reviews for inpatient rehabilitation, and tighten oversight over major hospital mergers and transactions.

Of the four lawmakers sponsoring this bill, Maria Cervania introduced the highest number of measures—45—during the 2025 regular session.

Bills in North Carolina move through a multi-step legislative process. A bill is filed by a legislator and sent to a committee. It must be read three times in both the House and Senate. If one chamber amends a bill after passage by the other, both chambers must agree on the final text. Once approved, the bill is sent to the governor, who has 10 days—30 if the legislature is out of session—to sign, veto, or allow it to become law without signature.

Find more information on session bills and legislative actions here.

Ball earned her BA at the University of North Carolina at Greensboro and later graduated from Virginia Commonwealth University.

Ball, a Democrat, was first elected to the North Carolina State House in 2017, representing the 49th district after replacing Gary Pendleton.