Health Care Act

By the numbers: North Carolina has big stake in health subsidies

The Affordable Care Act is subsidizing health insurance for a large and growing number of people.
The Affordable Care Act is subsidizing health insurance for a large and growing number of people. AP

North Carolina’s political leaders may not like the Affordable Care Act, but a large and growing number of residents rely on it for health insurance.

Only Florida, California and Texas have more people getting subsidized coverage than North Carolina, according to a new government report on 2015 enrollment.

That report shows about 515,500 North Carolinians qualified for aid, an increase of about 190,000 over 2014.

The meaning of the data will likely be debated as state and federal lawmakers wrangle over the act and the Supreme Court weighs a challenge to the subsidies in the Carolinas and 35 other states. But here are three quick lessons from North Carolina’s numbers:

1. Deductibles mattered.

Eighty percent of North Carolinians who qualified for aid could have bought a policy that would cost them less than $50 a month, but half of them chose a more costly premium.

That’s significant because people who choose the cheapest monthly payment can be ambushed by high out-of-pocket costs.

2. People shopped around.

Almost two-thirds of the North Carolina residents who re-enrolled in 2015 went online to register their choice, as opposed to letting their policies automatically renew. And 44 percent of those who went online chose a new plan.

Because of plan changes and rate increases, experts had advised that it was important to re-examine 2015 options. For North Carolinians who got subsidies, $410 was the average monthly premium, with $315 paid by the government.

3. Young people got covered, but enough of them?

This year, almost 45,000 children and 156,700 young adults (ages 18 to 34) in North Carolina got coverage through the marketplace. That’s 36 percent of the state’s total enrollment, matching the national average.

People ages 55 to 64 made up 23 percent of North Carolina’s total enrollment (at 65, people qualify for Medicare).

Age matters, because insurance companies say 2014 enrollment skewed toward older, sicker people, pushing up rates for everyone. The federal government says 2015 demographics are similar to last year’s.

Helms: 704-358-5033; Twitter: @anndosshelms. This article is done in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

Top states for subsidies

Approximate number of people who qualified for federal assistance buying health insurance in 2015:

Florida: 1.5 million.

California: 1.3 million.

Texas: 1.0 million.

North Carolina: 515,500.

In North Carolina

560,357 people selected policies in 2015.

51 percent were new customers.

49 percentextended coverage from 2014.

92 percent of all who enrolled qualified for help paying premiums.