Common misunderstandings

Executive Director Jim Barrett of Pisgah Legal Services clears up some points of confusion:

What specific populations is Pisgah Legal Services hoping to get enrolled?
Pisgah Legal Services is most keen on reaching uninsured people, especially populations that disproportionately lack health insurance: rural folks, African-Americans, people who speak English as a second language or not at all.

What's the response been like so far? Any surprises?
The federal website not working has been the biggest surprise and challenge. We've had to adapt and assist using phone and paper applications. We have postponed much of our outreach until the website is working faster. This delay has helped by giving us more time to train more volunteer navigators. The amount of time needed to meet with each customer has been longer than anticipated, partly because of the problems with the website and partly because of the need to resume the one-on-one sessions once the information about the subsidies becomes available.

What are the main public misunderstandings your organization has encountered about the process? What needs to be cleared up?
The lack of Medicaid expansion is incongruous to most people: Why would people above 100 percent of the federal poverty level be able to access health care and people below that figure can’t? Since the ACA was designed for the federal subsidies and Medicaid expansion to work together, there are cruel ironies and complications, because the N.C. General Assembly and governor chose not to use available federal dollars to provide health care to hundreds of thousands of our most vulnerable, poorest North Carolinians. These folks are surprised to find that the ACA will not help them in North Carolina.

Another misunderstanding is that people who have been terminated from their health insurance policies may not realize they will probably be eligible for more affordable and better policies through the federal exchange. Of course, there is a lot of angst because they cannot access the subsidies while the federal website is so slow. They can look on the Kaiser Foundation website ( for rough information about what their subsidies will be. They can make an appointment with a navigator to get started, or they can call the federal toll-free number for help.

Yet another misunderstanding is why there are winners and losers under the ACA. In order to give everyone a shot at affordable health insurance, more people need to go into the risk pool. That results in healthier, younger people having to pay a bit more in some cases — depending on their income.


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