RALEIGH – A North Carolina Business Court judge denied the State Health Plan’s emergency request to temporarily block Atrium Health’s new cost-sharing program, leaving the program on track to begin Jan. 1 while the underlying lawsuit continues.
Judge Matthew Houston issued the ruling from the bench Tuesday after a hearing in Sanford, according to Carolina Journal. The State Health Plan described the request as a temporary restraining order, while Atrium called it a temporary injunction. Neither party’s public release linked a written order.
The plan said Houston acknowledged its argument that Atrium’s program could cause irreparable harm. It also said it is exploring other legal options. The plan warned that the program could force it to consider premium increases of as much as $50 per month in 2028, a projection Atrium disputes. Those statements are the parties’ positions, not an independent finding about future premiums.
Atrium said the court found the State Health Plan unlikely to succeed on the merits and welcomed the decision. Atrium said its Affordability Protection Program will reduce what enrolled plan members pay for primary, specialty, outpatient and inpatient care at Atrium facilities. It says it will cover the reductions by collecting less from patients after the State Health Plan processes claims.
The dispute follows the plan’s move to a tiered provider network for 2027. Atrium is not in the preferred tier for many services. Atrium says its program will shield members from higher out-of-pocket costs. The State Health Plan argues that Atrium’s approach interferes with the treasurer’s authority to set deductibles, copays and coinsurance and could undermine the network’s finances.
The State Health Plan, Treasurer Brad Briner and the Treasurer’s Office filed the lawsuit Oct. 9 in Wake County Superior Court. The complaint sought emergency relief before open enrollment. Tuesday’s ruling denies that interim request but does not represent a final judgment on the lawsuit’s underlying claims.
Open enrollment has been extended through Nov. 6. Atrium says more than 80,000 plan members and family members use its providers, while the State Health Plan says the dispute could affect costs for members and taxpayers statewide.
Sources
- North Carolina State Health Plan response to the ruling
- Carolina Journal: Business Court ruling and party responses
- Atrium Health response to the ruling
Photo Credit: Wake Technical Community College photo of Treasurer Brad Briner speaking at an April 4, 2025 press conference, released under CC0 1.0 via Flickr and Wikimedia Commons.
Editor’s Note: This article was drafted with the assistance of artificial intelligence and was reviewed and fact-checked by a member of the NC Political News editorial team before publication.