North Carolina expanded Medicaid eligibility. Now what?

Life circumstances have left Jennifer Ring, who said she has survived three heart attacks, living on disability payments and without health insurance.

Ring, 54, attended a Medicaid expansion informational meeting in Ashe County earlier this month and left with an appointment that will include a guide to help her apply for health insurance.

Ring said she never thought of herself as someone who would turn to the government for help.

“Now I feel helpless because I can’t work,” she said. “I need help getting this insurance started.”

The state estimates that about 600,000 people in North Carolina are eligible for health insurance coverage under the Medicaid expansion.

When the Medicaid expansion kicked in on Dec. 1, nearly 273,000 people were automatically enrolled. They had coverage under the Medicaid family planning program and were known to qualify for full benefits.

Now the press is focused on finding the remaining hundreds of thousands of adults who are newly qualified for health insurance, asking them if they want to enroll, and helping them enroll if they do.

The state Department of Health and Human Services has hired individuals and organizations to disseminate the information.

The agency said in an email that 365 organizations or individuals have been trained to make presentations about the Medicaid expansion in English, and 111 have been trained to make presentations in Spanish. One hundred and seventy people told DHHS they were interested in learning how to help people sign up for insurance.

DHHS makes public the number of people enrolled in expanded Medicaid on a website launched this week. In a social media post, DHHS said 7,000 more people enrolled in expanded Medicaid in the first 12 days.

Studies show that expanding Medicaid leads to better diabetes management, reduced postpartum hospitalizationsand narrowed racial and ethnic disparities in access to health care.

Rural North Carolinians are disproportionately uninsured compared to people who live in cities or suburbs, Patrick Woody of the NC Rural Center told lawmakers last year.

Getting the word out about the expansion and helping people sign up means reaching all corners of the state.

That led the Down Home North Carolina group to an Ashe County town near the Virginia border, where it helped organize the meeting Ring attended. Representatives from organizations that help with enrollment also attended the meeting, including enrollment broker Maximus, a company hired by the state to help people choose health plans, and the NC Navigator Consortium, which helps people apply for Medicaid and for subsidized insurance through the Affordable Care Act marketplace.

Down Home is one of the organizations that advocated for Medicaid expansion, and now it’s committed to telling people it’s here. The Ashe County meeting was the first to expand Down Home, said Kate Daly, the organization’s health equity campaign leader. Down Home works in rural areas and plans to hold more Medicaid expansion meetings in places where it has branches or wants to open them, Daly said.

“There is a great need for information to reach rural communities,” she said. When she sent 6,000 text messages to Ashe County residents about the Medicaid expansion, many people didn’t know about it, she said, or thought she was talking about Medicare, the state health insurance for people 65 and older.

Some people in Ashe who are not eligible for expanded Medicaid have still requested information so they can share it, Daly said. That’s important because hearing about the expansion from friends and family is key to getting the word out, she said.

Ring actually heard about the Ashe meeting from someone at the county courthouse. “I would never know,” she said.

The NC Navigator Consortiumled by Legal Aid of North Carolina, has been helping people sign up for health insurance through the Affordable Care Act of 2013’s insurance marketplace, said Nicholas Riggs, director of the consortium.

Over the years, the consortium tried to deal with people who came for free advice but found they fell into the “Medicaid Gap,” meaning they made too little to afford subsidized health insurance but too much for regular Medicaid.

The Navigation Consortium is contacting those people again now, Riggs said, advising them to try again because their income may qualify them for insurance.

“We have a decade of conversations with different communities,” including underserved and immigrant communities, Riggs said. “It takes time for them to understand that the rules have changed.”

The Navigation Consortium coordinates events with other organizations, posts information on social media and operates media calls where navigators answer questions from people who learn about their free insurance guidelines from TV clips. WRAL reported that more than 3,200 people called navigators during his call earlier this month.

“I think all of these efforts together are comprehensive and fruitful,” Riggs said.

The NC Navigator Consortium can be reached at 855-733-3711.

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