Court Denies North Carolina State Health Plan Temporary Injunction and Rules NC State Health Plan Unlikely to Succeed on the Merits

Teachers, first responders, state employees and their families can keep choosing the Atrium Health care teams they know and trust

CHARLOTTE, N.C., Oct. 13, 2026 – Today the North Carolina Superior Court denied the North Carolina State Health Plan's request for a temporary injunction, ruling the NC State Health Plan is unlikely to succeed on the merits of their case.

Starting January 1, 2027, the Atrium Health Affordability Protection Program is designed to reduce costs for enrolled NC State Health Plan members at Atrium Health for primary care, specialty care, outpatient care and inpatient care. Through the Atrium Health Affordability Protection Program, deductibles and coinsurance are waived and replaced by a commitment, which lowers the cost members would pay at the Plan's own Preferred Tier. Atrium Health alone covers all costs of the program by reducing the amount it collects from the patient after each claim is processed by the NC State Health Plan.

"We're pleased by the court’s ruling to deny the temporary injunction," said Steve Smoot, president of Advocate Health's North Carolina and Georgia Division, which Atrium Health is a part. "From the very start, this has been about the people we serve: the more than 80,000 teachers, first responders, state employees and their families, from across North Carolina, who trust Atrium Health with their care. Thousands of State Health Plan members have told us they didn't want to choose between paying more and leaving the physicians and care teams who have walked with them through some of life's most serious health challenges."

What State Health Plan Members Need to Know About the Atrium Health Affordability Protection Program

• Who is eligible: Enrolled NC State Health Plan members, enrolled spouses and dependents, and retirees under 65.
• Who is not eligible: Any patients that have Medicare, Medicaid, Medicare Advantage, a managed Medicaid plan, TRICARE, or another similar federally supported plan, whether as primary or secondary coverage.
• No sign-up needed: There's nothing to sign up for. Starting Jan. 1, 2027, the lower copays apply automatically and show up on members' Atrium Health bills.
• One step to take: During open enrollment, which the Plan has extended through Nov. 6, 2026, keep or consider choosing an Atrium Health primary care provider.
• Learn more: www.atriumhealth.org/statehealthplan

The NC State Health Plan has suggested that the Atrium Health Affordability Protection Program could force premium increases for all of its members. As Atrium Health shared with the court, the Plan, however, has not shown how it reached that conclusion and whether the price increases to its members are the result of the Plan’s own flawed design. The NC State Health Plan has acknowledged that for years it relied on cash reserves to keep premiums flat while costs continued to rise, leaving those reserves nearly depleted and resulting in a reported $507 million deficit. Long before the Atrium Health Affordability Protection Program was introduced, the Plan had already increased premiums and deductibles. It also just received an additional $100 million from the North Carolina General Assembly for 2026 to address its financial challenges. The NC State Health Plan's financial problems did not begin with Atrium Health, and blaming a program that has not yet taken effect will not solve problems years in the making.

The Atrium Health Affordability Protection Program does not change NC State Health Plan benefits and does not increase what the Plan pays Atrium Health. Atrium Health bears the full cost of its Affordability Protection Program by accepting less payment from patients after the Plan processes each claim.

It is important for the NC State Health Plan to provide a fully transparent analysis behind any projected future premium increase including how much of any increase the Plan attributes to the program versus the Plan’s own design, how much reflects pressures that already existed, and what assumptions support a projection for a program that has yet to take effect.

There is also a common sense and straightforward solution to achieve the savings the NC State Health Plan says it needs. In a September 14 statement, the Plan said Atrium Health was "no more expensive than other leading health systems in North Carolina." Since learning of the NC State Health Plan's new tiered provider program, Atrium Health has repeatedly offered to match the Plan's Preferred Tier discounts and designation, and that offer still stands.

"We share the State Health Plan's goal of staying strong for the next generation of public servants," said Smoot. "Our offer to match the Preferred Tier discounts and designation is still on the table, and it would save the Plan money. We remain ready to sit down and find a path forward together, for every member the Plan serves."