***UPDATE: The Supreme Court has issued a 6-3 ruling allowing subsidies to continue to be offered in states that did not establish their own marketplace. You can read the full opinion here.***
The U.S. Supreme Court will release a decision within the next few days that may affect more than half a million North Carolinians who purchased health insurance through the Affordable Care Act.
The question before the Court in King v. Burwell is whether the federal government overreached when it allowed subsidies to flow to states, like North Carolina, that did not set up their own health insurance exchanges.
North Carolina is among 34 states that do not have state-run health insurance marketplaces. That means North Carolina residents who want to buy insurance through the Affordable Care Act have to do so through the federally-run exchange. About 550,000 North Carolinians did just that, and most of them, says Duke University public policy professor Don Taylor, received tax breaks to help pay for their premiums.
“Ninety-one percent of the North Carolinians have gotten a subsidy,” Taylor said, “and the average amount of that subsidy is about $315 a month.”
The plaintiffs in the case argue the Affordable Care Act does not allow the federal government to give those subsidies to people in states that don’t have a state-run exchange.
“So if the Supreme Court had a simple finding for the plaintiffs,” Taylor said, “then the tax credits that are coming to North Carolinians today, they would lose those tax credits, their insurance bills would then go up, and then presumably many of them would them drop their coverage.”
Taylor says not only would such a ruling affect those who dropped their coverage because they couldn’t afford the premium, it could topple the entire federally-run exchange:
“The problem is the people who wouldn’t drop coverage, the people who are desperate to keep their insurance, are probably people who are sick. And any type of insurance market—whether it’s car insurance, homeowner’s or health insurance—if the healthy people flow out because the premiums go up, and you only have sick people left, then that’s called ‘death-spiral,’ and that insurance market is unsustainable.”
If the Court does rule for the plaintiff, Taylor says depending on the details of the ruling, there could be some legislative fixes at the national and the state levels to keep the tax breaks coming.
“Maybe North Carolina could pass a simple law that says we desire for the subsidies to still flow in North Carolina. But then it’s back to a political question again.”
The Supreme Court is expected to release a decision by Monday, June 29.http://chapelboro.com/news/national/half-million-in-nc-await-scotus-obamacare-decision/
The open enrollment period to file an application for health insurance is coming to a close on February 15.
The Chapel Hill public library is offering assistance to those who are looking for help navigating the path to sign up for health care.
Shannon Bailey, the library’s Reference Librarian, says enrollment sessions are scheduled throughout the next week, leading up to an all-day sign up event on Friday.
“Anybody can come in and meet with a certified application counselor in our library computer lab,” she says. “And on Friday, Feb. 13, from 10 a.m. – 5 p.m. we will be hosting an all-day enrollment session.”
Leading up to Friday, Bailey says they will have sessions on Saturday, Feb. 7, from 1-4 in the afternoon, Monday evening from 5-8, and Tuesday afternoon from 2-5.
She adds they have picked Friday for their all-day session, even though the enrollment deadline is Sunday.
“We cannot predict, obviously, what the website is going to do this year,” she says. “We did learn from experience last year that the day before and the day of the site gets overloaded.”
Bailey says there are some things you will need to bring to sign up for coverage.
“In order to enroll, they will need their social security number – for themselves and everyone in their household that needs coverage,” she says. “They will need employer and income information for everyone in their household; that can take the form of W-2’s, wage statements, tax statements, [or] pay stubs.”
Bailey adds if you currently have any health coverage, you will need those policy numbers. And if you are eligible for health insurance from your employer, you will need to fill out a waiver on healthcare.gov.
Bailey says it takes a lot of teamwork to make this assistance possible.
“All of our certified application counselors are from UNC Healthcare, the League of Women Voters of Orange-Durham-Chatham, Planned Parenthood of Central North Carolina, and UNC’s Student Health Action Coalition,” she says.
You can call ahead to reserve a time during the enrollment session; walk-ins are also welcome.
This is the second year of open enrollment since the Affordable Care Act was put into place. The law provides subsidies to those who need assistance in paying for health coverage, and it makes having health care a requirement by law. Those who are not covered are subject to a fine.http://chapelboro.com/news/health/chapel-hill-public-library-offering-assistance-open-enrollment-deadline-looms/
Survival rates for those infected with HIV/AIDS in the South are the lowest across the nation.
Nine southern states, including North Carolina, are hit disproportionately hard by HIV/AIDS, according to new research out of Duke University. The study found 15% of those diagnosed with HIV, and 27% diagnosed with AIDS, died within five years of their diagnosis, based on numbers from 2003 – 2004.
Lee Storrow, Executive Director of the North Carolina AIDS Action Network, says the disease has grown beyond its initial profile of mainly affecting young-to-middle-aged white gay men.
“Unfortunately, we have really seen this disease evolve over the last 20 years,” he says. “[We’re] seeing a new focus and new outbreaks amongst poor residents of this county – and a concentration of new epidemics in the South.”
Storrow adds many factors play into the increased HIV rates – and the lower survival rate associated with the disease – particularly in our region.
“When you look at poverty rates in the deep South, when you look at lower levels of education, and you look at the social stigma,” he says, “I think all of those are factors that are contributing to increased rates of HIV in the South.”
Storrow says the stigma associated with the disease is a major obstacle in battling its treatment.
He adds, while sexual contact is the main form of transmission, the disease can also be passed by sharing needles, among other avenues.
Unfortunately, Storrow says our social environment can be deadly for those who are HIV positive.
“That stigma is something that means that people don’t share their medical conditions. They don’t receive testing,” he says. “And there’s a number of people who have received testing, and might know that they’re HIV positive, but aren’t actually in care to receive the treatment that they need.”
He adds battling the stigma is difficult on several layers, including not being able to legislate against a social stigma as you can with other more overt obstacles.
Of what can be controlled, access is a major theme for treatment, according to Storrow.
“One thing we know,” he says, “is that if you have access to stable-consistent-safe housing, you’re ability to access medical care significantly increases.”
And access to steady-affordable medical care can then translate to more effective treatment of the disease.
Storrow says the biggest way state legislators can help in the fight against HIV/AIDS is by expanding Medicaid.
He adds it will take teamwork – between lawmakers, everyone in our community, and beyond – to fight back against HIV/AIDS.http://chapelboro.com/news/health/hiv-survival-rates-disproportionately-low-south/
Following a court ruling last week, the state of North Carolina has begun recognizing same-sex marriages – and as a consequence, state employees (including UNC employees) will now be able to enroll same-sex spouses in the State Health Plan.
UNC Chancellor Carol Folt made that announcement Tuesday along with Felicia Washington, the Vice Chancellor for Workforce Strategy, Equity, and Engagement.
Their statement is below.
Dear Carolina Community,
On Friday, Judge Max Cogburn, Jr., a United States District Court Judge for the Western District of North Carolina, entered an order ruling that North Carolina’s law prohibiting same-sex marriages is unconstitutional as a matter of law. This is, indeed, a historic ruling in our state.
We are pleased to share with you that earlier today, the State Health Plan and NCFlex informed us that employees can immediately begin to enroll same-sex spouses. Coverage can become effective as early as November 1, 2014, for same-sex marriages performed prior to October 13, 2014. This applies to marriages performed in North Carolina, as well as same-sex marriages lawfully solemnized outside of North Carolina. Same-sex marriages performed after this date would be treated as qualifying events, just as with opposite-sex marriages.
Instructions to complete the enrollment of a same-sex spouse are available at http://hr.unc.edu/?p=20974.
We will continue to communicate any important updates relating to this late-breaking news. Likewise, we will inform you of any instructions we receive from the Office of State Human Resources, the State Health Plan and NCFlex related to any policy changes…
Carol L. Folt, Chancellor
Felicia A. Washington, Vice Chancellor for Workforce Strategy, Equity,
As the March 31st deadline for Americans to enroll in health care has come and gone, early estimates indicate that more than 7 million Americans successfully signed up for coverage, despite problems and long wait times.
Sherry Hay, UNC Family Medicine Director of Community Health Initiatives, says her department and community partners have been working to help locals sign up for health care since open enrollment under the Affordable Care Act began on October 1 of last year.
On Monday, Hay says UNC Family Medicine was still taking calls and answering people’s questions about enrolling for health care.
“Through the month of March, we tried to do a variety of events— some more global type of community events with other partners such as UNC General Internal Medicine and others in the community, to scheduling patients around their medical appointments here at family medicine to see a certified application counselor,” Hay says.
The last-minute rush before Monday’s midnight deadline was a headache for some, as people reported call wait times of more than two hours and constant glitches with the HealthCare.gov website. Such problems have plagued the system since its debut.
“During these tight times when we are all dependent on the system, it is really frustrating, and people were frustrated by that when it didn’t operate as it should,” Hay says.
Still, federal officials estimated that about 2 million Americans were able to successfully enroll in the two weeks leading up to the deadline.
According to data released in February, Hay says it was estimated that more than 200,000 North Carolinians had enrolled through the federal health care exchanges.
In 2013, 1.5 million people in North Carolina were uninsured.
“It has been an interesting change in healthcare, one of the biggest in decades. There was no state agency that was necessarily deemed the agency to be responsible for the change,” Hay says.
All people, with few exceptions, are required to have health insurance. People who are already covered by health insurance through a private provider are not required to change coverage.
Citizens who can afford health insurance but did not purchase it by the March 31 deadline will be fined $95.
However, the enrollment period has been extended for those who began the application but were unable to finish.
“The Obama Administration did release that if someone had started the process by midnight [on March 31st], they will have until April 15th to complete the application process,” she says.
Now that this open enrollment period has ended, Hay says UNC Family Medicine and its partners will regroup, assess what went well and what didn’t in helping to get people signed up and focus on the next open enrollment, which begins in November and runs through February of 2015.http://chapelboro.com/news/national/post-health-care-deadline-officials-say-7-million-enrolled/
How is the Affordable Care Act affecting small business owners in the Chapel Hill-Carrboro area?
The answer may depend on the gender of the workers they employ.
That, at least, is the tentative finding of a survey of local business owners conducted by the Chapel Hill-Carrboro Chamber of Commerce.
When asked how the Affordable Care Act was impacting them, 30.5 percent responded “negatively” or “very negatively,” while 23.9 percent responded “positively” or “very positively.” (The rest—not quite half—were either unaffected or unsure.)
But Chamber president Aaron Nelson says a closer look at the responses reveals something interesting.
“Some of that is about the neutralizing of men and women, (who) cost differently in the old world and cost the same now,” he says. “So if you had a predominantly younger female staff, your rates likely go down – (but) with a predominantly male staff…your rates could go up. So gender has had a real impact on cost.”
Nelson says auto body shops, in particular, have reported their health care costs going up—while the Chamber itself, with a mostly-female staff, has seen its costs decline.
Additional results from the survey are available at www.slideshare.net/carolinachamber/2014-economic-outlook-briefing (also the source of this image). As seen here, there’s only a slight lean towards the ACA having a “negative” effect if severity is not taken into account, but that changes if severity is considered: a far greater percentage of respondents reported a “very negative” effect than a “very positive” effect.
Nelson presented the results of the survey at last week’s annual Economic Outlook Briefing at the Sheraton Chapel Hill.http://chapelboro.com/news/business/gender-may-key-aca-impact-small-biz/
With tax season officially upon us, Orange County is once again offering the RSVP-VITA tax preparation service for low- to middle-income residents in need of assistance this year.
“VITA” is short for Volunteer Income Tax Assistance. It’s a free program sponsored by the IRS. It begins in February in Orange and Chatham Counties.
You can find out if you’re eligible and make appointments either online or by phone. Visit OrangeCountyNC.gov/aging/VITA.asp, or to make an appointment by phone, call:
Orange County: 919.245.4242 (English)
Orange County: 919.245.2010 (Spanish)
Compass Center for Women and Families: 919.968.4610 (English only)
Chatham County: 919.542.4512 (Angel Dennison)
Chatham County: 919.742.1448 (Spanish)
From now through March, the Hillsborough Arts Council is offering walking tours of the town’s sculptures. The guided tour is called “Take A Closer Look”; it will focus on four of the six sculptures that have been on display since last April.
Tours begin at the Hillsborough Arts Council Gallery on N. Churton Street, at 1:00 p.m. every Friday and Saturday. The tours are free (though donations are accepted), and they last one to one and a half hours.
This weekend brings the third annual “Mixed Concrete” art auction to Chapel Hill, with proceeds to benefit Habitat for Humanity. Featuring local artists working with a variety of materials, the show runs from Friday to Sunday, January 24-26, at TRU Deli + Wine Bar on the corner of Rosemary and Henderson. There will be an opening reception on Friday at 7:00 p.m.
To see some of the art online or to donate to the cause, visit MixedConcrete.org.
If you’re still unsure about the new federal Health Insurance Marketplace, UNC Family Medicine is holding a “Health Insurance Enroll-A-Thon” on Saturday, January 25, from 10:00 a.m. to 3:00 p.m. Officials will be on hand to answer questions and help you enroll.
The event will take place in the UNC Family Medicine Center at 590 Manning Drive. For more information or to schedule an appointment, visit UNCFamilyMedicine.org.
The Orange County main library in Hillsborough is hosting an exhibition of folk art from January 24-March 24. It’s called “Road Trip: Folk Art from Mike’s Art Truck”—and it’s comprised of 20 pieces all created by self-taught artists.
Curators Greg and Karen Mack of Hillsborough will be on hand for a reception at the library on Saturday, February 1, from 2-5 p.m.
Orange County’s Department on Aging and the Friends of the Seymour Center are inviting you to attend a Celebration Concert honoring the memory of Pearl Seymour on Saturday, January 25.
The concert will take place at 3:00 p.m. at the Seymour Center on Homestead Road; admission is free. Immediately following the concert, there will be a reception and a silent auction, with proceeds going to benefit the Department on Aging and the Friends of the Seymour Center.
For more information about the concert, visit FriendsSeymourCenter.org.
Saturday, January 25, you’re invited to a free performance of actor Mike Wiley’s “Dar He: The Story of Emmett Till” at 2:00 p.m. in the Chapel Hill Public Library. The performance is co-presented by the library and the UNC Program in the Humanities, part of a community dialogue on the legacy of Jim Crow and its impact today.
There will be an audience discussion following the performance.http://chapelboro.com/news/news-around-time/weekend-oc-arts-concerts-tax-relief/
CHAPEL HILL – Open enrollment for health insurance under the Affordable Care Act began on October 1, but many people have been dissatisfied with the sign-up process online.
The health care website has had a number of problems over the past month that have made signing up challenging, but Congressman David Price says that the health care website is going to be a valuable asset to many people.
“Many people are going to be depending on this and I’m confident that we will get it right, (though) I think the website problems are of course very regrettable,” Price says.
Although accessing the website has been difficult, people can visit the Piedmont Health Center in Carrboro to sign up, or even call the 24-hour hotline at 1-800-318-2596. Price says many people are working hard to get the website running right.
“We’ve got to get this website running and they’re working on it day and night. Reports I have had are that people are now getting through and that its improving day by day,” Prices states.
The Affordable Care Act website is only one of the concerns in Washington right now. Budget talks have begun in Congress and Price says there are many issues that will need to be reviewed.
“What are going to do about the fact that our tax code simply doesn’t pay our way? What about the long term future of entitlement programs like Medicare, social security? asks Price. “And what about the overly severe sequestration cuts, across the board cuts, that have already occurred?”
For more information about the Affordable Care Act, click here.http://chapelboro.com/news/national/affordable-care-actsigning-up/
CHICAGO – Millions of Americans will be able to shop for the first time today on the insurance marketplaces that are at the heart of President Barack Obama’s health care reforms.
The market places are opening in all 50 states, and the Obama administration hopes to sign up 7 million people during the first year.
The partial government shutdown will have no immediate effect on the insurance marketplaces because they operate with money that’s not subjected to the annual federal budget.
CHAPEL HILL – Sherry Hay, Director of Community Health Initiatives at UNC Family Medicine, says shopping in the marketplace will be similar to shopping for groceries at a supermarket.
“It’s just like looking at what items you would like to buy to feed your family. You can do that with health plans,” Hay says. “You can look at them side by side, and judge the benefits, the costs, and also see if you’re eligible for financial help.”
***Listen to the Interview***
Open enrollment ends March 31, 2014. Shoppers have until then to decide what plan they feel is best for them and their families.
Hay says there are some changes she feels Americans will be excited about.
“If you have a medical or pre-existing condition, you can get health coverage,” Hay says. “You will not be denied for that, as you were in the past.”
All Americans, with the exception of an exempt few, will be required to have health insurance.
Americans who can afford health insurance, but do not wish to purchase it will be charged a fine. There is financial aid available to eligible consumers. But not everyone has to purchase insurance through the federal marketplace.
If you already have health insurance through a private provider, you are not required to switch to the federal pool.
”It’s really important just to begin looking, and thinking, and pulling your information together,” Hay says. “The important thing is to really take charge and empower yourself.”
For more information about the healthcare marketplace, you can visit www.healthcare.gov.