A frequently asked question: Why Does Project Access Still Need to Exist if the Federally Facilitated Marketplace Rolls out on October 1, 2013?

August 20, 2013

Currently, Project Access income criteria require that patients fall below 138% of the Federal Poverty Level (FPL) in order to be eligible for Project Access. PA patients below 100% FPL will likely remain completely uninsured and need PA as they have no other affordable options. They do NOT qualify for subsidies to help them afford insurance in the marketplace. They get no help from the Affordable Care Act. Why? Because the ACA was written with the assumption that each state would expand Medicaid to cover all low-income people below 138% FPL.  Currently, because of strict eligibility rules, Medicaid only covers 30% of low income adults in North Carolina. North Carolina did not expand Medicaid to cover 100% of low income adults. Thus, for the foreseeable future, most of our current PA patients will continue to need PA, and many more very low-income people will be lining up at Project Access to get their serious medical needs addressed.

Please note that about 30% of current PA patients fall between 100-138% FPL; these patients DO qualify for subsidies in the Federally Facilitated Marketplace in NC. To help this subgroup of PA patients move from free care delivered by PA to subsidized insurance, we have redirected about 35% of our 2013 Mission grant funds to hire and train a full time Certified Application Counselor, who will work to make this happen over the next year.

 

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