North Carolina is one of the many states that did not accept funding from the federal government to expand our medicaid program. Expanding the medicaid program would have broadened the qualifying income levels so that more people would be eligible for free health insurance. North Carolina opted out of this because the funding was only guaranteed for 3 years, and then NC would have to either fund the expanded program itself, or drop those people off the program. NC has had trouble funding the state medicaid system in the past, and the idea of trying to come up with the funds to support an expanded program seemed like a terrible idea.The problem now is that we have what I have named, the "Black Hole" in our healthcare system in North Carolina. There is this big void between medicaid eligibility and qualifying for a federal subsidy on the Exchange.
If you are single(file as single on your tax return) and are not on disability or of Medicare age, you are not eligible for medicaid. If a single person make less than $12,000 a year, then they do not qualify for a subsidy on the Federal Exchange. It doesn't matter how old you are, unless you are eligible for Medicare, in which case you won't be purchasing insurance on the Exchange.
Earlier this year I had a man come into the office to get a quote for health insurance. He was 62, so he was not old enough for Medicare, he had no dependents, and was not legally disabled. He had some health problems, and he only worked sporadically. He brought in his tax forms from the year before showing that his total annual income was $1,800. He received food stamps, and that's what he lived on. I was incredulous that this could be the only money he had made. I questioned his daughter, who was with him, about whether she paid for more than 50% of his bills(therefore qualifying him as a dependent on her taxes), but she insisted that she did not, that $1,800 was what he lived on. In this situation, if $1,800 was truly all of his income...there was nothing I could do for them. This man did not qualify for medicaid because he was single, and did not qualify for a subsidy because he made too little money. The monthly rate for this man would have been $400-$500 a month for health insurance, which he clearly could not afford.
Fortunately, there is a a Free Clinic in Rockingham County that can assist this man on a basic level. A person can qualify to go to the Free Clinic if they have no health insurance(no Medicaid or Medicare), if they are a local resident, and if their income falls within Federal Poverty Guidelines. Their services are limited, but they are wonderful people that do anything and everything they can to get help for their patients.
I was pretty humbled by this man's situation. I personally feel I pay too much for health insurance for my daughter and I, but I realize now that I should be grateful for my situation because there are some people that can't afford health insurance at all. Health Insurance in the next couple of years will get only more chaotic if the Supreme Court decides that states without their own exchange cannot access the federal subsidies that residents are currently getting. While I do not want to offer my personal opinions on the Affordable Care Act, I am eager to see the chaos die down so that people will feel more secure about their health insurance.
Open Enrollment for 2016 will begin November 1st and end January 31st. If you have questions about how to navigate health insurance in the coming year, call our office(336-342-4438) for a quote or contact me by email. We work with Blue Cross and Blue Shield, Humana, and Assurant Healthcare, as well as Medicare Supplement plans.
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