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Originally published: 2014-01-16 18:38:48
Last modified: 2014-01-16 18:43:15

NC fifth in marketplace enrollment

by Anna Oakes

Figures released by the U.S. Department of Health & Human Services Monday reveal that North Carolina was fifth among states in the numbers of people who, as of Dec. 28, had enrolled in health insurance plans through marketplaces established by the Affordable Care Act.

Between Oct. 1 and Dec. 28 of last year, 107,778 North Carolinians selected a plan via the Health Insurance Marketplace, the DHHS news release said.

The total fell behind enrollee numbers in California (498,794) and New York (156,902), which operate state-run marketplaces, and Florida (158,030) and Texas (118,532), which, like North Carolina, participate in the federally run Health Insurance Marketplace.

Of those who enrolled in North Carolina, 89 percent are eligible to receive tax subsidies to help pay for their insurance premiums, according to the news release.

Eric Schneider is the outreach and eligibility specialist for High Country Community Health, the federally qualified health center serving Watauga and Avery counties. High Country Community Health received funding last year to hire Schneider and another part-time employee to help the public understand the ACA and enroll in plans through the marketplace.

Schneider said the outreach and enrollment team -- which also includes a volunteer -- assisted more than 700 people in the two counties during the first three months of marketplace enrollment. The team helped more than 60 people enroll and 100 people apply for insurance on the marketplace as of Dec. 23, Schneider said, but he noted that the marketplace website, healthcare.gov, was not functioning properly until mid- to late November.

Lee Millman, media affairs officer for the Centers for Medicare & Medicaid Services Atlanta Regional Office, said county-level data on enrollment numbers is not available at this time.

High Country Community Health recently received additional federal funding to expand outreach and enrollment efforts prior to the March 31 open enrollment period deadline.

"We anticipate a huge rush in February and March," Schneider said.
With that funding, the center has hired and trained three new full-time employees to assist with its efforts. Their areas of focus will include hospital patients, the college student population and the more isolated communities in the area.

Schneider said many people in Watauga and Avery -- where many businesses do not offer health insurance benefits -- will qualify for the federal premium subsidies available to people with incomes between 100 and 400 percent of the federal poverty level, which was $11,490 for a single person and $23,550 for a family of four in 2013.

But Schneider noted that about a third of the people he has assisted in Watauga and about half of the people assisted in Avery were not eligible for the subsidies for various reasons. Subsidies are not available to people who are eligible for affordable coverage offered through an employer or a spouse's plan or to those who fall in the "Medicaid gap" -- people with incomes less than 100 percent of the federal poverty line but not eligible for Medicaid. In North Carolina, only low-income children, mothers, seniors and the disabled can receive Medicaid benefits.

The ACA provides exemptions to the individual mandate's tax penalty for those who cannot afford health insurance -- but they must apply for the exemption before March 31, Schneider said. The High Country Community Health outreach and enrollment team can assist local residents in applying for the exemption, he said.

"It's a lot of work, but they need to do it," he added.

Schneider urged local residents who are interested in learning more or applying in the marketplace to make an appointment with High Country Community Health as soon as possible and not to wait until the 15th of the month -- the deadlines to receive coverage beginning on the first of the following month. Team members are also available to speak to groups.

For more information, call Schneider at (828) 773-7297.