That's because North Carolina—along with 22 other states—did not expand Medicaid to people with incomes up to 138 percent of the federal poverty threshold. Above that level, the law gives people subsidies to buy private insurance, but the Supreme Court allowed states to opt out of the law, and many did, creating the gap.
"I take someone who's working poor, I ask them to come see me, and then I find out that not only are they poor, but they're too poor for me to help," Buckner told Gold. "It's almost as if I wished I hadn't seen them." Buckner has worked with some people to come up with a way for them to reach the poverty line, which is annual income of $11,500 for a single person; that way, they can qualify for a subsidy. People often don't realize that income can come from many sources. "Folks are trying to use every source of income, whether it's selling tomatoes from their garden, or perhaps they've never actually sold the hay off of their field; they've just always let their nephew cut it for free," Buckner said.
While many struggle to qualify for insurance, some success stories make Buckner hopeful for the future, Gold writes. Chuck Cantley, 62, learned his premium would rise to $1,100 a month from $240, so he applied for reduced Social Security benefits, which put him at the poverty level and qualified for health coverage. "The folks that have been able to sign up—they are ecstatic," Buckner said. "And as long as we keep hearing success stories, that energy and excitement are going to grow." (Read more)