RALEIGH, N.C. (AP) — North Carolina residents and small businesses will be able to shop for private health insurance in an online marketplace scheduled to open in October as part of President Barack Obama's health care overhaul.
Former Gov. Beverly Perdue, a Democrat, set North Carolina on a course for the exchange that's required by the federal Affordable Care Act to be run jointly by the state and federal government. But the state's Republican-led General Assembly and Gov. Pat McCrory could decide to have Washington be the sole operator of the state's exchange, as other GOP-led states have done.
As legislators start their new terms this week, here are answers to some of the questions about how North Carolina's exchange is likely to shape up:
Q: How far along is North Carolina in setting up an exchange?
A: Perdue said in November that North Carolina would run a health care exchange jointly with the federal government, but the hybrid system can be changed later. Perdue said she consulted with McCrory ahead of her decision. Some state legislative leaders remain skeptical about developing a health insurance exchange, arguing that federal regulators will make all the rules.
Q: How many people are uninsured in North Carolina and how many of those are projected to get insurance under the exchange?
A: One goal of the health care overhaul law is reducing the number of people under 65 who lack health insurance. In 2011, that number was 1.55 million in the state, according to the latest estimate by the North Carolina Institute of Medicine, an independent agency that receives state funding and provides health policy analysis and advice.
About 715,000 North Carolinians are expected to buy coverage through an exchange in 2014, growing to more than 900,000 people by 2016, according to the institute, which studied the effects of the law on North Carolina for the state Department of Health and Human Services. About 300,000 of those projected to buy coverage through the exchange are currently uninsured, according to Milliman Inc., a consulting firm hired by the state Insurance Department to forecast how the exchange would be used. Currently 18 percent of state residents under 65 lack health insurance but that figure is expected to drop to 8 percent in 2014, the consultants' report said.
Q: How many people are currently served by Medicaid and how many more will be served if North Carolina chooses to expand coverage through the program?
A: More than 1.5 million people in North Carolina currently receive health care paid by Medicaid. About 648,000 more state residents with low incomes who currently lack insurance would be eligible for Medicaid coverage if North Carolina chooses to expand the program. About 525,000 of those people would enroll in Medicaid or North Carolina's child health insurance program in 2014, according to the state Division of Medical Assistance.
Q: How many small businesses are likely to take advantage of the health insurance offered on a North Carolina exchange?
A: Of the estimated 715,000 North Carolinians expected to buy health insurance coverage through a state exchange beginning in 2014, about 51,000 people are expected to be covered by small businesses purchasing insurance for employees and their dependents, according to the Milliman study.
Q: How much money has North Carolina received so far from the federal government to do the initial work in setting up an exchange?
A: North Carolina this month was awarded $74 million by the U.S. Department of Health and Human Services to keep working on the state's exchange, in addition to $13.4 million previously awarded to pay for planning, salaries and information systems.
Q: How many people will North Carolina's exchange employ and how much will it cost?
A: Reports from two consulting companies estimated that running North Carolina's exchange would cost about $25 million a year. One of the consultants reported in 2011, before the experience of early-adopter states and subsequent regulations, that about 110 workers would be needed to fulfill the exchange's functions if it were a stand-alone agency but fewer if it were made part of an existing state government department.