About 20 protestors rallied before the N.C. Department of Health and Human Services Thursday morning to express frustration that state officials are doing little to promote the new health care law.
Brandishing placards, the protestors denounced the state government's passivity as "criminal," "sabotage" and "missing in action."
With less than two weeks to go before enrollment begins for subsidized insurance, polls continue to show that a significant portion of the nation's population is ignorant about, or confused by the nation's health care law, the Patient Protection and Affordable Care Act.
States that are actively promoting the Affordable Care Act received substantial federal grants for outreach and enrollment. North Carolina declined to cooperate and turned away $27.2 million in federal assistance for promotional activities.
"We're concerned that there's a concerted effort to sabotage its implementation," said Candice Davies of Protect Your Care NC.
The health care law makes insurance mandatory and provides federal subsidies to offset insurance costs for some people.
The Raleigh protest underscores lingering anxiety here and elsewhere about chronic delays in implementing the complex health law. Without state government backing, outreach efforts in this state will likely be uneven across North Carolina's 100 counties.
Earlier this year North Carolina officials declined to extend Medicaid coverage to about a half-million people. Many of those people will remain without coverage as the Affordable Care Act goes into effect Jan. 1.
Still, North Carolina officials have not taken proactive steps to interfere with the law as have some other states. Florida and others have passed laws establishing licensing requirements for the "navigators" who will be trained to coach the public on the intricacies of the law.
Florida also has banned navigators from promoting the law at county health departments.
North Carolina, meanwhile, is distributing information to county social services departments to refer the public to www.healthcare.gov, the official web portal for the law. And navigators will be welcome at local agency offices.
"We encourage all Social Services Agencies to allow navigators to work onsite if your facility can accommodate them," the NC DHHS wrote to the agencies on Wednesday. "This will provide valuable assistance to those who are interested in purchasing a plan through the federal exchange."
North Carolina's outreach and enrollment is being handled by hospitals, nonprofits, volunteers and local agencies.
Enrollment for subsidized coverage runs from October through March, and coverage begins Jan. 1. Failing to enroll will be subject to a fine of $95 or 1 percent of annual pay, whichever is greater. The fine increases in subsequent years.
The Affordable Care Act prohibits insurers from charging women higher rates than men, from charging older people more than three times more than younger people pay, and from rejecting customers with pre-existing conditions.
"People are coming to understand the benefits of Obamacare," said Brenda Cleary, a Cary nurse who works as a healthcare consultant. "Some of them will have health insurance for the fist time in their lives."
Gov. Pat McCrory told reporters that he and and DHHS Secretary Aldona Wos will present an update next week on "the impact of Obamacare on North Carolina."
He noted that IBM, Duke Energy, and other companies are changing the way they offer health insurance to retirees.
"I actually predicted this last year when Obamacare was passed, that you'd start seeing people walk away from their own private insurance programs," McCrory said.
Adam Linker, a health policy specialist at the N.C. Justice Center, said Duke Energy's decision has nothing to do with the new health care law. He worries that McCrory and Wos will spread "untruths" about the new law.