The Affordable Care Act (ACA) granted many North Carolinians access to coverage where it didn’t exist before. Prior to the 2013–2014 open enrollment period, the estimated number of uninsured, non-elderly individuals in Wake County hovered around 130,000—nearly 15% of our community. Healthcare reform provided an opportunity for many people to enroll in affordable insurance through the North Carolina Health Insurance Marketplace, and enroll they did! Nearly 360,000 people enrolled statewide by April 2014, and Wake County surpassed enrollment predictions early on.
However, many individuals fall into the “coverage gap,” an income range too low to qualify for premium tax credits but too high to qualify for coverage through Medicaid, because, in North Carolina, Medicaid wasn’t expanded to cover low-income, childless adults without disabilities. Between 25,000 and 30,000 adults in Wake County fall into this category. A number of others don’t qualify because of their immigration status.
For many, fortunately, nothing has changed in Wake County—they’re still getting care through the network of organizations that have served the uninsured for years. We’re working with community stakeholders to educate and enroll as many people as possible with private insurance through the Marketplace. Moving people to private insurance opens up healthcare options, both in our programs and at our community clinics, for those with even fewer resources.
Our programs continue to focus on people with chronic and complex medical and behavioral conditions, the homeless, and people needing either information about the importance of primary care or assistance accessing services. We’re expanding our Project Access program to focus on dental health, building on a medical model of donated care that has worked for 14 years.
Our aim continues to be connecting our clients to a medical home and reduction of hospital visits. Our innovative processes have shown great success in these areas; nearly 80% of our enrollees have found a primary care home, and a significant reduction in emergency department (ED) and hospital admissions has been achieved.
Since 2006, concerned members of the Wake County healthcare community have worked, collaboratively, to improve efficiencies, increase access, and create a system of coordinated care for the uninsured. Our network is the CapitalCare Collaborative, and I welcome you to our Website. I encourage you to use our information and resources and, in return, I hope you will provide us with your feedback and good ideas.
To apply for health coverage through the Marketplace, go to www.healthcare.gov. To schedule an appointment for in-person assistance with enrolling in a plan, call 855-733-3711 to meet with a Health Insurance Marketplace Navigator.