SALISBURY — So far, Obamacare has not resulted in the flood of phone calls and Medicaid applications that Rowan County Department of Social Services expected.
But Director Donna Fayko says it’s coming.
“We will see a huge increase in applications,” Fayko said.
In North Carolina, which declined to expand Medicaid to cover most poor residents, people applying for a discount on health insurance through Obamacare first must determine if they’re eligible for Medicaid.
Few people realize that a Medicaid screen is the first step of shopping for health insurance in North Carolina, Fayko said.
The new health insurance marketplace created by Obamacare, also called the Affordable Care Act, will screen North Carolinians to see if they’re eligible for Medicaid. If it appears they may qualify, their applications will be sent electronically to local social services departments.
Applications for people who are not eligible for Medicaid will return to the marketplace, where they can shop for insurance and apply to qualify for a subsidy from the federal government, Fayko said.
People who earn between 100 and 400 percent of the federal poverty level — $62,040 for a couple or $94,200 for a family for four, for example — will qualify for subsidies that will offset the cost of buying health insurance.
The North Carolina eligibility requirements have not been loaded into the federal marketplace yet, “so we are not seeing a significant impact at this time,” Fayko said. “We will see the impact in December when people are scrambling.”
The online marketplace — www.healthcare.gov — has been plagued with problems. Once the site is up and running well, Fayko said she expects people to call DSS for help enrolling. The DSS phone number is listed as a resource for Rowan County.
“We’ve had no phone calls so far,” she said.
Separate from Obamacare, Rowan County DSS already has its hands full with another online Medicaid initiative.
The agency is working to convert between 25,000 and 27,000 Medicaid cases into NC FAST, which stands for North Carolina Families Accessing Services through Technology. The new tool is used to enroll low-income people in Medicaid, food stamps and other public assistance programs.
Fayko has hired six temporary workers for six months to help with the NC FAST conversion before the expected onslaught of Medicaid applications from Obamacare.
The state will pick up half the cost of the workers’ salaries, leaving the county to pay about $41,600. Fayko said she’s using funds already in the DSS budget from lapsed salaries, so she hasn’t had to find new money.
“These staff would have been necessary to assist with DSS operations through the NC FAST conversion for Medicaid, regardless of the Affordable Care Act,” she said. “DSS has not yet seen a direct impact from the ACA but feel certain that we will at a later date.”
Social services, the Health Department and Novant Health Rowan Medical Center will host an Obamacare information and enrollment event from 3 to 7 p.m. Nov. 14 at the Civic Center. The event is free and open to the public.
“We are trying to raise awareness and answer questions,” Fayko said. “Most folks are baffled by the whole change. Even some of our legislators don’t understand it.”

Contact reporter Emily Ford at 704-797-4264.