RALEIGH, N.C. (AP) — North Carolina was among the top states for people buying health insurance on the state's federally run marketplace, nearly doubling initial expectations.
The state's enrollment — almost 360,000 people in private insurance plans, two-thirds of those eligible — was exceeded only by California, Florida, Texas and New York, the Obama administration said Thursday.
The response came despite the decision in early 2013 by Republican lawmakers to resist the federal health overhaul law. They deciding against developing a state-run health insurance marketplace and turned away almost $74 million in federal grant money to help build it and hire nearly 600 people to help explain it.
Instead the federal government ran the subsidized insurance market, and private groups stepped in to promote it.
A collection of more than 40 hospitals, community health centers and social-safety-net organizations created what they called a "big tent" effort to get people to sign up. Blue Cross and Blue Shield of North Carolina, the only insurance company offering plans statewide in the marketplace, invested heavily into drawing a broad pool of people into its plans. A national nonprofit that worked closely with the Obama administration made North Carolina a priority. A single statewide toll-free number fed into scheduling appointments with in-person assisters in the caller's county.
"Obviously those groups have been very successful," said Rep. Nelson Dollar, R-Wake, vice chairman of a state House committee on health and human services. He said he was eager to see research describing who signed up for coverage, who followed through and paid their premiums, and how many were buying replacements for policies canceled because they didn't meet minimum requirements under the law.
A report this week by the House Energy and Commerce Committee said 74 percent of North Carolina enrollees paid their premiums for coverage by April 15. The average for the nearly three dozen states with federally run marketplaces was two-thirds of enrollees making payments.
A coalition of churches, legal aid teams, social welfare groups, and health centers participated in the big tent effort. They swapped stories about what worked, such as setting up information drives at community colleges.
Efforts to reach insurance consumers were funded with more than $3 million from the Obama administration and about $1 million more from the Kate B. Reynolds Charitable Trust, a statewide philanthropy based in Winston-Salem. The money supported more than 300 paid or volunteer workers trained to shepherd consumers through the process of buying policies on the exchange, said Lee Dixon, a consultant who organized the "big tent" coalition.
The Reynolds trust, established in the 1940s by the wife of the tobacco magnate who ran R.J. Reynolds Tobacco Co., says it works to improve the health of the state's poor. About 80 percent of the trust's enrollment spending went toward putting feet on the streets, said Allen Smart, director of the trust's health care division.
"When the state decided to be less involved," Smart said, "there was the ability to just say, OK, we've got to gather ourselves and figure out an effective way to approach what is, we thought, a critical opportunity we didn't want to miss."
Blue Cross advertised on TV and billboards and with a recreational vehicle pulled up to festivals and street fairs. It opened retail-like stores in places consumers shopped and hosted events explaining the law and how to buy insurance.
North Carolina was also among 11 states targeted by the national group Enroll America, a nonprofit backed by charities, insurers and pharmaceutical companies. That brought additional money and volunteers handing out brochures at farmers markets and visiting churches before or after Sunday services. Volunteers dispatched by the group made door-to-door visits in a campaign-style effort.
Neither Blue Cross nor a division of Aetna, the only other company selling policies on the exchange to North Carolina consumers, would describe how many policies they sold on the marketplace.
Emery Dalesio can be reached at http://twitter.com/emerydalesio.