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What will happen for low income ppl in states that opted out?

In a state like North Carolina where a decision has been made not to participate in ACA - does that mean low income or unemployed individuals will continue to not have medical coverage?  My mom doesn't work - I support her financially.  We live in MN so she is able to get coverage through the state's generous Medical Assistance program.  We are looking to move to NC and the fact that she will not be able to get medical coverage in NC pretty much stopped us from relocating.  While I could financially support her...private medical insurance is too expense for me to buy for her.  She is not old enough to get Medicare and she is not disabled or anything to qualify for Medical Assistance in most states.  I believe MN is one of the very few states that currently provides medical coverage for people below certain income level.


Does anyone know how things will work in 2014 for a state like North Carolina?  Also, how about a state like CA where the current Medicaid program does not offer medical coverage for low income adults without children under 18 - will these individuals be covered in 2014 through the Medicaid expansion of ACA?


  • Hi @MNMom07:

    For other readers out there, it's important to note that North Carolina has opted out of the Medicaid Expansion provision of ACA, not opted out of ACA all together.  ACA is federal law and states cannot opt out.  North Carolina has also chosen not to setup and run their own state exchange, thus the federal government is setting up the state exchange for NC.

    The exchange to purchase insurance in NC is scheduled to be online in October.  Thus, perhaps this is an option for you, at least to see how much it will cost since all plans must meet certain guidelines and all plans will be available to all buyers, regardless of medical history, i.e. they cannot deny your mother.

    Comments from others out there?

  • Posts: 11
    Federal subsidies may be available, or, if shes otherwise healthy, and youre willing to "gamble," you may choose to pay the tax "penalty" rather than buying expensive coverage.
    Thanked by 1Bob_Moderator
  • Posts: 6
    Contact NC politicians about this and tell them this stopped you from moving to their state. They need to know this. If you had a job there, this lack of a move hurts their economy
    Thanked by 2Bob_Moderator acam
  • Posts: 1
    You mom might qualify for a federal subsidy.  There are two types: Advance Premium Assistance and Cost Sharing Assistance.  If qualified, the first subsidy will lower the insurance premiums.  The second subsidy will lower co-pays, deductibles, out-of-pocket expenses (She would need to buy a silver plan to receive this subsidy, though).  

    If after a subsidy, she still cannot afford premiums through the exchange look into resources for the uninsured.  For example (if qualified), she can enroll in patient assistance programs that greatly reduce the prices of prescriptions or even sometimes provide them free of charge.  

    Thanked by 1Bob_Moderator
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