Today is the first day of open enrollment for the Affordable Care Act  Marketplace. And while North Carolinians have reason to celebrate the increase in coverage  for many adults and families, there are still as many as 500,000 Tar Heels who would gain coverage if state lawmakers decided to fully implement the ACA and close the coverage gap.
Several recent reports — both scholarly and in the commercial news media — have brought home this point in powerful fashion.
One of the most compelling is a new video report by VICE News.  The report features Reidsville family practice physician, Dr. Stephen Luking and provides powerful evidence of how the coverage gap impacts so many individuals and families throughout North Carolina. In addition to Dr. Luking, you can see the heartrending story of Angela and Roger Smith, who are forgoing their own health care to care for their son even though he has Medicaid.
The VICE News report comes on the heels of a recent report by the N.C. Poverty Research Fund  that highlights how failure to close the coverage gap not only hurts individuals lacking insurance, but impacts their families, providers, and communities. The report shows how many hard working people make sacrifices like quitting their jobs to become full-time caregivers to loved ones. Once in that role, they often lack health coverage themselves and oftentimes experience poor health and financial outcomes as a result. The report also quotes Dr. Luking on the sacrifices one of his patients makes in order to care for his mother:
“I think of the caring, middle-aged man I saw recently in my office. He once had good insurance and a full-time job at a factory but had to quit his job and come home when his mother suffered a devastating illness. Otherwise, she would have been forced into a nursing home. I had placed him on several medicines for health issues. When I asked him if he had done his blood work, he started to cry. He told me he now had no insurance. The folks at social services had told him he wasn’t earning enough to qualify for insurance subsidies [under the ACA]. He now works for minimum wage 25 hours per week and told me he has been skipping medicines in order to make ends meet.”
Yet another report — this one by the Center for Children and Families  — explains that over a quarter of people in the coverage gap are parents. This includes parents like Angela and Roger and Linda Dunn (who was featured in this WCTI TV report earlier this year) . Both the Smiths and Ms. Dunn (and their children) would experience significant financial and health benefits if North Carolina closes the gap.
Finally, you can click here  to see maps that show just how much North Carolina and the 18 other non-expansion states are falling behind compared to expansion states.
The bottom line: Yes, the ACA has helped decrease the number of uninsured in our state, but we still desperately need full ACA implementation in order to make the law work at its full potential and improve the lives and health of hundreds of thousands of North Carolinians.