Some find they’re not eligible for subsidies

Published 12:00 am Sunday, February 9, 2014

The Community Care Clinic is continuing to encourage its patients to enroll for insurance under the Affordable Care Act. However, Krista Woolly, the clinic’s executive director, says that some clients are still not be eligible for care.
Because North Carolina did not expand Medicare coverage, Woolly says, adults who have no children at home or are not disabled are not eligible for subsidies if they make less than $11,490 per year, the 100 percent federal poverty level for a one-person household.
“That’s not a lot of money,” Woolly points out, “but it is if you don’t have a job.”
Beginning Feb. 10, the clinic will have a certified navigator, Dianna Wald, who will enroll clients by appointment only each Monday. For clients who qualify, Wald could enroll up to seven people or households per week. It takes about an hour to enroll in the insurance program with assistance. To sign up, you must bring all Social Security numbers for people living in the household and evidence of taxable income such as pay stubs, disability income stubs or Social Security income stubs.
Wald, based at Davidson Medical Ministries in Lexington, can help clients set up accounts, select plans and answer billing questions.
“I am paid for by ACA, and I am not an insurance broker,” Wald notes. “I give clients information and let them make the decision.”
Woolly would also love for volunteers to come and help sign up patients.
The assumption for those not covered by the ACA is that they would be covered by Medicaid. But that is simply not true, Woolly says. ACA only covers adults whose income is at 48 percent to 100 percent of the poverty level, and who have minor children at home.
“We have this huge gap of people who don’t have minor children, who are not disabled, and who don’t make 48 percent of the poverty level,” Woolly says. “It’s a lot of people.”
“Our poorest of the poor are not being served by this program,” Wald says.
The insurance subsidies are meant to cover individuals making 100 percent to 400 percent of the poverty level.
Additionally, if you don’t meet the 100 percent guidelines, you cannot be penalized.
Wald points out that the clinic will keep seeing clients because of the Medicaid gap. It still needs donations, and still needs volunteers.
Since last summer, Woolly has attended classes and workshops on ACA. People can sign up for coverage by the 15th of each month to get insurance benefits the next month, with the current deadline of March 31.
Woolly has seen numerous glitches in the enrollment system, such as identity verification. Another problem is enrolling families. Woolly notes that while one of her clients has insurance, he can’t afford to add his family.
“The family needs to go on ACA and he needs to be left alone,” Woolly says.
Latest estimates tell us that there are some 1.6 million North Carolinians who are uninsured, and Woolly says that’s probably a low estimate. Woolly herself was hoping to sit down and help enroll clients, but the enrollment process has turned out to be more complicated than she envisioned.
“It became very clear to me that this cannot be a self-serve process,” she says.
Some folks have been going to the library to enroll, and Woolly says that library staff has been eager to assist.
“But it’s not as easy as it looks,” she stresses. “It’s not a difficult process. It’s just time-consuming.”
The clinic is seeking volunteers to assist people with applications. If you’d like to help, call the Community Care Clinic at 704-636-4523. You may also use this number to sign up for an appointment with Dianna Wald, the navigator.

Freelance writer Susan Shinn lives in Salisbury.