As part of the Affordable Care Act, states were given an option to establish their own marketplace, share the responsibility with the federal government or use the federally facilitated marketplace. North Carolina initially considered establishing its own marketplace, but reversed that decision, which resulted in turning away millions of federal dollars to create a system of information and support for citizens to navigate this change.
Recent news reports noted that many people were frustrated by glitches with the federally facilitated marketplace as they tried to shop online. In contrast, The New York Times reported that California, which established its own marketplace and invested $94 million in state dollars in addition to federal support for getting the word out, had more than 29,000 people who were helped in completing 16,000 applications for health coverage in the first five days.
It is clear to me that many of the 1.5 million uninsured people in North Carolina will need help in understanding what the insurance marketplace could mean for them. This includes explaining to the approximately 500,000 of North Carolinas uninsured those who would have been covered by Medicaid in 2014 had the state decided to expand Medicaid that they will continue to be without health insurance because they live below 100 percent of the federal poverty limit and are ineligible for subsidies.
At the ground level, I have been participating in a variety of community events over the last several weeks to discuss the ACA and the new marketplace. I have been encouraged by the number of people who have come to these meetings with their earnest questions, yet I am also concerned by a cloud of misinformation that is just below the surface. For example, I was asked by one older gentleman whether panels in Washington are going to make decisions about the necessity of performing surgery, and whether people on Medicare would no longer be covered through that public program.
Based on my recent experience, it is hard for me to ignore the blatantly wrong information that is being promoted by a number of advocacy groups who have chosen to instill fear rather than revealing facts about the marketplace. For example, a TV ad sponsored by Americans for Prosperity highlights Tricia, a woman who has twice battled cancer, in conversation with a larger audience about the wonders of our current system, largely because of the support received from her health care providers. Although the ACA does not regulate your choice of health care provider, Tricia falsely concludes that Obamacare is dangerous since your well-being will be determined by a Washington bureaucrat.
All North Carolinians need and deserve real information in order to choose the best health plan for themselves and their families. Here in our state a variety of groups, such as Enroll America, Legal Aid, Community Care of North Carolina, and safety net providers have come together to help people in their local communities understand their health care options in the new marketplace by providing honest and accurate information.
Most are doing this important work with limited funding and are facing an uphill battle to counter the misinformation that is all around us.
Americans value freedom, especially in the choices that are most personal to us like health care, and our best choices are made when we have true information that is not clouded in fear.
Sherry Hay, MPA, is the Director of Community Health Initiatives and Adjunct Assistant Professor in the Department of Family Medicine at the University of North Carolina at Chapel Hill.