North Carolina maintains the fourth-highest enrollment under the Affordable Care Act, but the state saw a 6.6 percent drop in enrollment, among the largest declines in the nation, from April through June 30.
According to the latest federal figures issued Tuesday, North Carolina’s ACA enrollment dropped to 459,714 from 492,014, as 32,300 people who bought individual health insurance policies failed to make monthly payments or canceled coverage.
North Carolina’s enrollment lags only behind Texas (943,218), Florida (1.3 million) and California (1.4 million). The state’s success in signing up uninsured people for federally subsidized health insurance is largely attributed to the organizational acumen of nonprofits and social service organizations that mobilized “navigators” to promote the ACA’s benefits.
A falloff in enrollment was not unexpected after the open enrollment period closed February 15, after which only those who had a major life event, such as a new child or a job loss, could buy ACA health insurance. Open enrollment for 2016 coverage begins Nov. 1 and ends Jan. 31.
“There is natural turnover with all insurance programs,” said Adam Linker, a health policy analyst with the N.C. Justice Center in Raleigh. “There were a few outlier states but North Carolina remained stable.”
Nationwide enrollment also dropped, to 9.9 million from 10.2 million, even as some states saw an increase in their insurance rolls. Massachusetts, for example, saw a 26.1 percent surge in enrollment, gaining 32,438 people.
Florida’s 7.1 percent three-month decline amounted to 101,091 people dropping out of the ACA insurance rolls. Georgia’s 7.7 percent decline came to 34,925 people.
The Centers for Medicare & Medicaid Services, which administers the health care law, issued the summertime enrollment figures as part of its policy to issue quarterly updates. Tuesday’s release is the first to reflect enrollment fluctuations while the program is not in open enrollment.
Linker predicted that enrollment in 2016 will be moderate in comparison with the big gains of 2014 and this year. Customers will face stiffer penalties for failing to obtain health insurance: $695 for individuals, up to $2,085 for families, or 2.5 percent of household income above the tax filing threshold.
Meanwhile, rates will be increasing for most customers, although the subsidies are likely to offset the rate increases for many.
The Affordable Care Act requires most Americans to buy health insurance if they already don’t have coverage through their employers or under a federal program like Medicare or Medicaid.
The law also prohibits industry practices common in past years, such as turning away people with pre-existing conditions, or charging more to customers who have serious illnesses.
The law provides financial aid to people whose household income falls between 100 percent and 400 percent of the federal poverty level. As of the June 30 tally, 91.6 percent of ACA policies in North Carolina were subsidized at an average of $315 a month. In the March 31 tally, 93.2 percent were subsidized at $316 a month on average in North Carolina.