Robeson County in eastern North Carolina had the highest percentage of enrollments under the Affordable Care Act, with half the county’s eligible residents signing up for health insurance.
An analysis by UNC-Chapel Hill’s NC Rural Health Research Program shows that generally between a quarter and a third of eligible residents enrolled in many counties, with a range between 9 percent and 42 percent statewide.
To qualify as eligible for subsidized health insurance, a resident must meet specific criteria, such as legal residence and a household income between 100 percent and 400 percent of the federal poverty level. Most individual policies sold through the “marketplace” under the Affordable Care Act were subsidized.
The U.S. Department of Health and Human Services last month released enrollments by zip code, and did not list any area with 50 or fewer enrollments. UNC researchers cross-checked those enrollments against estimates of eligibility by county to determine “uptake” rates.
In the Triangle, 27.6 percent of eligible residents selected a health plan in Chatham County, 32.6 percent in Durham, 28.3 percent in Orange, 19.1 percent in Johnston and 32.8 percent in Wake. In Mecklenburg County, 34.3 percent selected plans.
In Robeson County, which has one of the highest poverty and crime rates in the state, 49.9 percent selected a plan, with an estimated 7,000 enrolling out of 13,000 eligible. Robeson was heavily targeted by trained “navigators” and other outreach and enrollment efforts by advocacy groups and social service organizations.
The next-highest rate was Avery County, with 41.7 percent, while Gates County came in dead last at 9 percent.
The percentages reflect residents who selected a plan by mid-August, the only data provided by federal authorities. Insurers have since said that some residents never paid their first premium, or stopped paying premiums after several months, so actual enrollments are lower than the numbers of people who selected health plans.
The Department of Health and Human Services has not updated the 6-month-old enrollment numbers.