1. United States
2. N.C.
3. Letter

I am a North Carolina constituent writing to demand that you take immediate and concrete action to protect and improve healthcare access for the people you represent—especially those in rural communities. North Carolina has over 1 million residents enrolled in ACA marketplace coverage, many of whom live in rural counties with limited healthcare options. If the enhanced ACA tax subsidies expire, premiums are projected to rise by an average of 90% nationwide, pricing thousands of North Carolinians out of coverage. Rural families, farmers, and small business owners will be hit the hardest. I urge you to take the following actions: 1. Extend the ACA tax subsidies for at least three years. More than 80 of North Carolina’s 100 counties are considered rural or partially rural, and many have only one hospital—or none at all. Stable insurance coverage keeps rural hospitals open and prevents emergency rooms from becoming the only point of care. 2. Lower the Medicare eligibility age to 55. Adults aged 55–64 in North Carolina face some of the highest insurance premiums in the country, particularly in rural areas with little insurer competition. Expanding Medicare eligibility would provide affordable coverage for older workers and caregivers while helping stabilize rural healthcare systems. 3. Work with Democrats to replace the ACA with a universal healthcare system modeled on Tricare or the VA. North Carolina already relies heavily on federally supported systems to deliver care in underserved areas. Tricare and the VA prove that government-run healthcare can deliver lower costs, broad access, and high patient satisfaction. A universal system would reduce administrative waste and ensure that no North Carolinian—rural or urban—is forced to delay care due to cost or lack of coverage. North Carolina has seen multiple rural hospital closures in the past decade, and many more are financially at risk. Failing to act on healthcare affordability will accelerate this crisis and deepen health disparities across the state. Healthcare is not a partisan issue. It is an economic, moral, and public health necessity. I expect you to represent the needs of North Carolinians—not insurance companies or party ideology—and to work across the aisle to deliver real solutions. I will be closely watching your actions on these issues.