In North Carolina, Affordable Care Act gains threatened by funding cuts

Affordable Care Act enrollment runs through Dec. 15. It offers health care access to many who might not realize it.
Affordable Care Act enrollment runs through Dec. 15. It offers health care access to many who might not realize it. AP file photo

I grew up in Lumberton, where I have many positive memories of family, church and the community. But I was also acutely aware of the historical divides and significant gaps in opportunity, particularly health care. As an African American child, that is not lost on you.

After medical school, I returned to Lumberton as a pediatrician in the local clinic where I used to go for care. I saw thousands of children and their families, many facing serious health challenges, impacted by economic and racial inequities.

Today, I serve as president of the Kate B. Reynolds Charitable Trust, where we value thriving North Carolina communities, thriving residents, and equitable health outcomes — and this means equitable access to health insurance.

Thanks to the Affordable Care Act, many more residents now have access to affordable health insurance plans. Last year alone, more than 524,000 North Carolinians signed up for health care coverage. And nine out of 10 people received financial aid to help them pay for their health plan.

But those gains are threatened by funding cuts. Federal support for enrollment assistance in our state has been drastically cut from $3 million to $500,000. Our state legislature has not expanded Medicaid coverage, leaving thousands — seniors, children and rural residents — without access to health insurance.

Just as Mrs. Reynolds stood up for the health of North Carolina residents in 1947, today we must stand up for our residents by ensuring everyone has access to affordable health care. Our state does best when we all do best.

But many people in this state are living below the poverty level and are uninsured. And they face challenges learning about and signing up for insurance plans. In rural counties, many residents don’t have access to the Internet or public transportation and might not even have a bank account because they deal in cash. Imagine trying to enroll in or pay for health insurance if you can’t go online or get to the public library computer or submit an electronic payment.

We know these challenges create barriers to enrollment. That is why, since enactment of the Affordable Care Act, the Trust has invested more than $10 million in North Carolina nonprofits that provide in-person assistance to help residents understand the marketplace and gain coverage. We support organizations like Mountain Projects and Legal Aid that are working round the clock in this enrollment period and beyond.

For example, when a 19-year-old woman from Waynesville and her mother, who is disabled and unable to work, lost their health coverage, Mountain Projects was there. They helped identify the best choice for their family — and at lower cost. With Mountain Projects’ assistance, the family just enrolled for next year with a $200 lower deductible and a lower co-pay, enabling them to afford health care for the mother’s diverticulitis and spinal stenosis.

During open enrollment through Dec. 15, the NC Navigator Consortium, a network of six community-focused non-profits led by Legal Aid staff, are calling thousands of residents and hosting hundreds of friendly walk-in events for people to learn about what’s available in the health insurance marketplace and to sign up for a plan that best fits their needs and budget.

At a recent community event, a 4-year-old boy hugged the Legal Aid staff after his father was able to enroll in an affordable plan. He expressed joy that his father would now be able to go to the doctor!

Efforts like this are part of a statewide campaign for enrollment assistance that Legal Aid and the NC Navigator Consortium have been championing. State residents can call 855-733-3711, or visit to book a free appointment with a certified in-person assister in their community. This system has become a national model replicated in 11 states.

Access to health care is not a partisan issue, it’s a public health issue. It’s our collective responsibility to make sure everyone knows they can enroll, offer support to organizations helping with enrollment, and continue to advocate for expanded access to Medicaid and equitable access to health care for all.

Gerald is president of the Kate B. Reynolds Charitable Trust. For questions, contact Nora Ferrell at 336-397-5515 or