WCMS Foundation Counsels 111 Project Access® Program Patients About The Health Insurance Marketplace

May 14, 2014


Since 1996, Western Carolina Medical Society Foundation has been dedicated to helping the uninsured access health care services through its nationally recognized program, Project Access®. When Health Information Exchanges became a reality in late 2013 thanks to the Affordable Care Act, WCMS enrolled with the federal government to become a “Certified Application Counselor” entity.

Between January 1 – March 31, 2014, WCMS’s 1.5 Certified Application Counselors (CACs) who were fully trained as Health Insurance Navigators, provided ‘inreach’ counseling to current Project Access® patients about the Health Insurance Marketplace (HIM), outreach counseling about the same to the patients of physicians throughout WNC, and counseling to the general public.

During the first three months of 2014, WCMS CACs reached out to 698 Project Access® (PA) patients who were thought to be potentially eligible for HIM. Well over 1,000 “touches” were made through mail and multiple telephone calls, while WCMS CACs conducted 150 face-to-face interviews with 111 individual Project Access® patients from our pool of 698 eligible PA patients.

Of the 111 PA patients counseled:

  • 54% (60) enrolled in the marketplace and obtained insurance,
  • 32% (35) were under 100% FPL—too poor to qualify for subsidies -- and returned to Project Access®
  • 14% (16) opted to pay the tax penalty  

“The Western Carolina Medical Society Foundation works on behalf of our physician constituents and by extension, their patients,” says WCMS CEO Miriam Schwarz. “This has allowed WCMS CAC’s to ‘go the extra mile’ to insure that newly insured people understand how to use their insurance. We do not want patients showing up at the hospital or doctor’s office having not paid their premium or being unable to afford the deductible/co-pay. We call them several weeks after enrolling them to insure that they’ve paid their first premium; and we refer them to On Track Financial to learn how to budget for this new expense.”

Aside from the PA pool, an additional 21 non-PA patients were enrolled into HIM (they found us on the CMS website or were referred to us). Of the 81 successful exchange enrollees, 85% self-reported purchasing the Silver 3000 Blue Advantage plan, with premiums under $30 a month and a $500 deductible.

“The time and service of my Certified Application Counselor through WCMS” says former Project Access Patient C. D. “gave me the peace of mind that comes with purchasing health care coverage through the Insurance Marketplace.”  

But unfortunately, the ACA does not help the poorest of the poor. The ACA provides federal subsidies for people between 100-400% of the Federal Poverty Level.  The ACA was written with the assumption that States would expand Medicaid for people under 100% of the Federal Poverty Level, but North Carolina did not provide this expansion. Ms. Schwarz observes that “many of our poorest friends, neighbors and co-workers will continue to rely on Project Access® to keep them alive.” In 2013, more than 3,000 low-income, uninsured patients were given access to free health care they couldn’t otherwise afford. Through this partnership with over 500 area physicians, medical services valued at more than $8 million were provided to these patients.  

Contact: Miriam Schwarz
828.274.2267 ext. 312