Cost of Living Plan

Two Practical Steps North Carolina Can Take to Lower Costs

Families across Western North Carolina are being squeezed by costs they cannot avoid.

Groceries and healthcare consume more of household budgets, while wages have struggled to

keep pace.

North Carolina cannot control every force driving prices higher. But Raleigh has tools it can use

right now. My cost-of-living plan starts with two practical steps.

At a Glance

• The Grocery Tax Relief Plan: A one-year break on the local grocery tax, fully covered by the state so counties, schools and public safety funding aren't affected. No application, no form, no waiting list. Families see the savings automatically at the register.

• Carolina Health Choice: A new, affordable health insurance option for anyone who isn't offered affordable coverage through a job today. Whether you're self-employed, work for a small business, or work for a large employer that simply doesn't offer you coverage, with no one denied coverage or charged more for a preexisting condition.

 

1. The Grocery Tax Relief Plan: Give Families a One-Year Break on the Grocery Tax

Pause North Carolina's 2% local sales tax on qualifying groceries for one year and have the state replace the revenue local governments would otherwise receive.

Families would see the relief immediately at the checkout line, while local governments would continue receiving the resources they rely on, including revenue currently dedicated to public school capital needs as well as funding for public safety and other essential services.

There would be no application, no form and no waiting list. Families would receive the relief automatically when they buy qualifying groceries.

Where Would the Money Come From?

The North Carolina General Assembly's nonpartisan Fiscal Research Division estimates that the 2% local grocery tax generates approximately $550 million to $600 million annually for local governments.

The enacted 2026 state budget leaves $1 billion unappropriated in the General Fund and identifies other substantial nonrecurring state resources. I am proposing that the General Assembly use available state resources to make local governments whole during the one-year grocery tax pause.

The current $1 billion unappropriated General Fund balance alone is larger than the legislature's estimated cost of a full year of grocery tax revenue. That gives North Carolina the fiscal capacity to provide families temporary relief without simply shifting the cost onto local communities.

The proposal is straightforward: pause the 2% local grocery tax for one year, use state resources to replace the revenue local governments would otherwise receive, and give families immediate relief at the checkout line.

HB 1032, introduced earlier this year, would permanently repeal the grocery tax, but it has not passed the House and remains in committee. The bill does not include a mechanism to replace the revenue local governments would lose. My proposal instead pairs grocery tax relief with a state backfill to protect local budgets, including revenue currently dedicated to public school capital needs.

2. Carolina Health Choice: A New Affordable Healthcare Option for North Carolina

Create another health insurance option for North Carolinians who do not have access to affordable coverage through their jobs. Whether they work for themselves, for a small business that cannot afford to offer traditional group health insurance, or for a large employer that simply does not offer them coverage, such as many part-time and hourly retail and restaurant workers.

Think about the independent consultant, the self-employed plumber, the person running a one-person business, someone working for a small local employer that simply cannot afford a traditional group plan, or the retail and restaurant worker at a national chain whose hours are kept below the threshold that would require an insurance offer. Too many of these North Carolinians are left facing the individual insurance market without an affordable choice.

I want North Carolina to build another one.

The state would work with competing private insurers to create a state designed health insurance option focused on affordability, quality and access.

For small businesses that cannot afford traditional group insurance, North Carolina should also examine how existing federal mechanisms can allow employers to contribute toward employees' individual coverage. That could give small employers another way to help their workers afford healthcare without requiring them to operate a traditional group health plan.

What Would Make This Different?

• Protect people with preexisting conditions. No medical underwriting. Nobody should be denied coverage or charged more because they got sick.

• Use competition and purchasing power to lower costs. Private insurers would provide the coverage. The state would establish strong standards and use competition among participating insurers to drive better value.

• Attack unnecessary costs instead of shifting them onto patients. Cost savings should come from smarter purchasing, competition, reduced unnecessary administrative costs, greater transparency and better ways of paying for care, not from excluding people who need healthcare.

• Protect rural healthcare. This is essential for Western North Carolina. We cannot lower someone's insurance premium by destabilizing a rural hospital, driving physicians out of mountain communities or making it harder for people to find a provider.

Rural hospitals, doctors, nurses and other healthcare providers should be at the table when North Carolina develops reimbursement and network standards. A North Carolina plan should include specific protections for critical access hospitals, small rural hospitals and other essential providers rather than imposing a one-size-fits-all reimbursement formula.

Learn From What Other States Have Tried and Build It Better Here

North Carolina does not have to start from scratch.

Washington launched the nation's first state-designed option, Cascade Care, in 2019, with coverage beginning in 2021. Colorado's Colorado Option followed, with coverage starting in 2023. Nevada and Minnesota are building similar programs now. In every case, private insurers, not the government, deliver the coverage, the same model I'm proposing for Carolina Health Choice. Washington's early rollout also taught a real lesson: because hospitals weren't required to participate, provider networks were thin in some areas.

We should learn from both.

The goal is not to copy another state's system. It is to take what works, learn from what doesn't, and build a North Carolina solution that lowers costs while protecting access to care, especially in rural communities.

The Bottom Line

This is what problem solving in Raleigh should look like.

The Grocery Tax Relief Plan gives families immediate relief on groceries. Carolina Health Choice creates another affordable healthcare option for people who need one, and gives small businesses another way to help their employees. Both protect county budgets, protect school capital funding, protect people with preexisting conditions, and protect rural healthcare.

North Carolina has the ability to act. We should use it

Cost-of-Living Plan

Frequently Asked Questions

THE GROCERY TAX RELIEF PLAN

  • Yes. North Carolina does not impose the general state sales tax on qualifying groceries. Instead, qualifying groceries are subject to a 2% local sales tax, and the revenue goes to local governments.

    My proposal is to pause that 2% local grocery tax for one year and have the state replace the revenue counties and other local governments would otherwise receive.

    That distinction matters. I don't want to give families tax relief by creating a financial problem for their counties.

  • The North Carolina General Assembly's nonpartisan Fiscal Research Division estimates that the 2% local grocery tax generates approximately $550 million to $600 million annually for local governments.

  • The enacted 2026 state budget leaves $1 billion unappropriated in the General Fund. The General Assembly's nonpartisan Fiscal Research Division estimates that the 2% local grocery tax generates approximately $550 million to $600 million annually for local governments.

    I am proposing that the General Assembly appropriate available state resources to make local governments whole during the one-year pause. The current $1 billion unappropriated balance is larger than the legislature's estimated cost of a full year of grocery-tax revenue.

  • Not under my proposal.

    The state would replace the grocery tax revenue local governments would otherwise receive during the one-year pause, including revenue currently dedicated to public school capital needs. The goal is to give families relief without forcing communities to cut essential local services or putting additional pressure on school construction and other school capital needs.

  • Because this is temporary, targeted cost-of-living relief. Families would get immediate help at the grocery store, while counties and municipalities would continue receiving the revenue they rely on for essential local services.

    And families would not have to apply for the relief, fill out a form or get on a waiting list. They would simply see the savings every time they buy groceries.

    North Carolina currently has the fiscal capacity to consider doing both. The point is not to shift the burden from families to counties. It is to use available state resources to give families some breathing room while making local governments whole.

  • Because this is designed to provide immediate cost-of-living relief while protecting local budgets.

    I am proposing a one-year pause as a responsible place to start. During that year, lawmakers can evaluate economic conditions, state revenues, the impact on families and the cost of making local governments whole. If the relief is working and North Carolina has the resources to continue it responsibly, lawmakers could extend the pause.

    The point is to give families meaningful relief now without making promises about future state finances we cannot yet predict.

  • Yes. Republican legislators introduced HB 1032 in April 2026 to repeal the 2% local grocery tax permanently. The bill has not passed and remains in committee.

    Unlike my proposal, HB 1032 does not replace the revenue local governments would lose, including revenue currently dedicated to public school capital needs.

    My proposal takes a different approach. I am proposing a one-year pause coupled with a state backfill so families get the same relief at the grocery store without shifting the cost onto counties, local services or public schools.

CAROLINA HEALTH CHOICE

  • I want North Carolina to create another affordable health-insurance choice for people who do not have access to affordable coverage through their jobs.

    That includes people who work for themselves, independent contractors and sole proprietors, employees of small businesses that cannot afford to offer traditional group health insurance, and employees of larger companies — including national retail and restaurant chains — who simply are not offered coverage, often because their hours are kept below the threshold that triggers an employer's obligation to offer it.

    North Carolina would establish strong affordability, coverage and access standards and work with competing private insurers to offer the coverage.

  • They're included too. Federal law only requires large employers to offer coverage to employees who work 30 or more hours a week, and many large employers schedule workers below that threshold specifically to avoid that requirement. Eligibility for Carolina Health Choice shouldn't depend on how big your employer is. It should depend on whether you were actually offered affordable, adequate coverage through your job. If you weren't, whether you work for a five-person shop or a national chain, you should be able to enroll.

  • No.

    Private insurance companies would provide the insurance. The state would establish the rules and standards for participating plans and use competition and statewide scale to drive better value for consumers.

    The goal is another choice, not eliminating the choices people already have.

  • Yes. That is nonnegotiable.

    The plan I am proposing would preserve protections for people with preexisting conditions. There would be no medical underwriting that allows an insurer to deny someone coverage or charge that person more because they got sick.

    We should lower healthcare costs by making the system work better, not by excluding people who need healthcare.

  • Because insurance premiums reflect more than an insurance company's administrative costs or profits. They also reflect what the insurer must pay hospitals, physicians, pharmacies and other providers for healthcare.

    Simply ordering an insurer to charge less without addressing those underlying costs can lead to losses, narrower provider networks or insurers leaving a market altogether.

    A state-designed option gives North Carolina another tool. The state can establish affordability and quality standards from the beginning, invite private insurers to compete to participate, and address unnecessary costs throughout the system rather than simply putting a cap on the final premium.

  • North Carolina should use several tools rather than relying on a single blunt cost cut.

    Those can include:

    • Competition among private insurers seeking to participate.

    • Using statewide scale and competitive procurement to get better value from participating private insurers.

    • Limits on unnecessary administrative expenses.

    • Standardized plan designs that make it easier for consumers to compare coverage and price.

    • Greater healthcare price transparency.

    • Payment models that reward good outcomes and effective primary and preventive care rather than simply paying for more services.

    • Careful negotiation of healthcare costs while protecting access to essential providers.

    The goal is to squeeze unnecessary costs out of the system without destabilizing the people and institutions communities depend upon for healthcare.

  • The goal should be to build a system that works better for patients and the people who care for them.

    When more North Carolinians have affordable coverage, patients are better able to seek routine and preventive care, and providers can face less uncompensated care.

    North Carolina should also learn from Washington's and Colorado's experience with provider reimbursement in their public-option programs. We should not simply impose a one-size-fits-all payment formula that fails to recognize what it actually costs to provide care in different communities.

    That is particularly important in rural North Carolina. Rural hospitals, doctors, nurses and other healthcare providers should help design the reimbursement and network standards from the beginning.

  • Rural protection should be built into the plan from the beginning, not added after problems develop.

    North Carolina should establish specific protections for critical-access hospitals, small rural hospitals and other essential providers. Reimbursement standards should recognize that providing healthcare in a rural mountain community is different from providing it in a large metropolitan market.

    Rural hospitals, doctors, nurses and other healthcare professionals should have a seat at the table when reimbursement and network standards are developed.

    We cannot call insurance affordable if people cannot find a doctor or if the hospital they depend upon cannot stay open.

  • Yes. There are viable pathways for states to create state-designed health insurance options within federal healthcare law. The final design would need to comply with Affordable Care Act requirements and any applicable federal approvals.

    The important question is how North Carolina designs an option that lowers costs, protects people with preexisting conditions and preserves access to care, particularly in rural communities.

  • Washington launched the nation's first state-designed option, Cascade Care, in 2019, with coverage beginning in 2021. Colorado's Colorado Option followed, with coverage starting in 2023. Nevada and Minnesota are building similar programs now. In every case, private insurers — not the government — deliver the coverage, the same model I'm proposing for Carolina Health Choice.

    Washington's early rollout is also an important lesson. Because hospitals weren't required to participate, provider networks were thin in some parts of the state. That is exactly why my proposal insists rural hospitals, doctors and nurses help set network and reimbursement standards from the beginning, not after problems emerge.

     

  • Yes. House Bill 1175, the Affordability in Healthcare Act, was filed in April 2026 by Representatives Cervania, Crawford, Ball and Belk. It would create a state-facilitated, low-cost health plan on the ACA exchange, with private insurers competing under state-set affordability and quality standards. I think that is encouraging because it shows there is already a legislative path for moving this idea forward.

    My proposal would build on House Bill 1175 while strengthening several elements that are particularly important to Western North Carolina. I also want North Carolina to learn from the experience of states that have implemented similar approaches, including what has worked and where problems have emerged.

    Most importantly, I want rural healthcare protections to be central to the design from the beginning. Rural hospitals, doctors, nurses and other providers should have a seat at the table in developing reimbursement and network standards. We should make sure critical-access hospitals and other essential rural providers are protected rather than relying on a one-size-fits-all approach to controlling costs.

    I also want the plan focused on people who do not have access to affordable employer coverage — self-employed North Carolinians, employees of small businesses that cannot afford traditional group insurance, and employees of larger companies who simply aren't offered coverage — while preserving protections for preexisting conditions and prohibiting medical underwriting.

    If existing legislation provides a vehicle for getting there, I would work with lawmakers from either party to strengthen it and get it done. The goal isn't to introduce another bill. The goal is to solve the problem.

  • Employees of small businesses that cannot afford traditional group health insurance are among the people I want this option to help.

    North Carolina should also examine ways small employers can use existing federal mechanisms to contribute toward employees' individual coverage without requiring the business to establish and administer a traditional group insurance plan.

    That could give a small employer another way to help employees afford healthcare.

  • No.

    This is about creating another affordable choice for North Carolinians who need one. It is not about taking existing coverage away from anyone.

THE PRINCIPLE BEHIND THE PLAN

Why these two proposals?

Because groceries and healthcare are expenses families cannot simply stop paying. I want to focus on things North Carolina can actually do to lower those costs.

The grocery proposal provides immediate relief while protecting county budgets.

The healthcare proposal tackles a much more difficult problem by creating another choice for people who need one, protecting people with preexisting conditions, and addressing underlying costs without sacrificing rural healthcare.

I don't think Raleigh needs more arguments about problems everybody already knows exist. I think it needs people willing to work through the details and build solutions.