New North Carolina House bill seeks broader health coverage, stricter hospital oversight

Rep. Sarah Crawford has submitted a bill to the North Carolina House that would extend health coverage and bolster oversight of hospital pricing and practices, according to the North Carolina State House.

Known as HB 1175, the bill was filed on April 30 in the 2025 regular session and is officially listed under the short title: ‘Affordability in Healthcare Act.’

The following summary provides a breakdown, based on the actual bill text, and may include explanatory interpretation.

The measure creates a statewide, affordable health plan on the ACA marketplace by 2028, limits administrative expenses, and ties premium and cost-sharing calculations to specified affordability standards. It establishes a Public Health Purchasing Consortium to coordinate public purchasers and allocates $25 million in recurring funds and $10 million in nonrecurring funds beginning July 1, 2026, in addition to $175 million to maintain and broaden Healthy Opportunities Pilots focusing on chronic disease prevention. Further provisions enhance transparency around hospital pricing, quality, billing, and facility fees; ensure patients receive reliable cost estimates with strict limits for overcharges; safeguard essential rural health services; update rules on prior authorization, including placing restrictions on AI-based denials; remove certificate-of-need review for inpatient rehabilitation facilities; and impose tighter regulations on major hospital consolidations and transactions.

Among the four bill sponsors, Maria Cervania introduced the highest number of bills—45—during the 2025 regular session.

The legislative process in North Carolina follows a multi-step path before a bill becomes law. A legislator files a bill, which is then assigned to a committee for consideration. The bill must be read three times in both chambers. If either chamber amends it after the other has passed it, both must agree to a final version. Once both chambers approve the identical text, it heads to the governor, who has 10 days (or 30 if the legislature is adjourned) to sign, veto, or allow it to become law without a signature.

Find more information about bills and related actions here.

Crawford earned her BA from North Carolina State University in 2003.

Crawford, a Democrat, was first elected to the North Carolina State House in 2023 to represent the 66th House district, succeeding former Rep. Ben Moss.