Buncombe clinic prepares for more patients if ACA tax credits expire

ASHEVILLE, N.C. — Nearly 1 million people in North Carolina can expect to pay more for health insurance next year unless Congress acts to extend the Affordable Care Act’s insurance premium tax credits. They are set to expire Wednesday, making policies less affordable.


What You Need To Know

  •  Insurance policy costs under the Affordable Care Act are expected to increase in 2026
  •  Premium tax credits expiring and rising health care costs are contributing to the increase in policy prices
  •  The  Asheville Buncombe Community Christian Ministry Medical Ministry offers free medical and dental care to those without insurance 



For three years, Dr. Daniel Frayne has served as the director of the Asheville Buncombe Community Christian Ministry Medical Ministry

The clinic serves uninsured Buncombe County residents who earn less than 250% of the federal poverty level.

This year the free clinic served about 3,200 patients seeking medical care, dental care and medication – which Frayne says is a significant growth from previous years.

“We’ve been seeing a lot of that as well, a lot of folks with insurance who can’t get into care. And so we’re bridging that care, too,” he said.

The 2024 Buncombe County Community Health Assessment reports that 13% of county residents under 65 live without health insurance. Frayne expects this number to increase as the average rate for individual insurance policies in North Carolina will go up by nearly 29% in the new year.

What we know is that people get into bankruptcy and are constantly in debt because of health care costs. So this is like, this is a cliff. I expect lots of people to forgo insurance,” Frayne said.

North Carolina Insurance Commissioner Mike Causey says in a press release that he attributes the price hikes to increased health care costs and the expiration of federal subsidies. He encourages people to maintain health insurance through job-based coverage, private insurer or a student health plan.  

Frayne says the clinic commonly diagnoses and treats patients with diabetes and high blood pressure. For patients with chronic diseases, access to consistent health care can prevent major health complications.

“These are the things that we need to prevent, you know, so anybody who has these conditions, who is not seeing physicians, who is not being well managed, eventually they’re going to end up in the emergency room, they’re going to end up in the hospital,” he said.

Open enrollment for Affordable Care Act insurance coverage runs until Jan. 15.

The medical clinic is open for walk-ins Monday through Thursday from 9 a.m. to 11 a.m. and Monday afternoon from 2 p.m. until 4 p.m.  

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Jordan Grantz

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