Expanding Health Insurance Coverage to More North Carolinians

North Carolina Task Force on Covering the Uninsured: April 2006

The percentage of people without health insurance coverage is growing at a faster rate in North Carolina than in most of the rest of the country. Currently, more than 1.3 million nonelderly North Carolinians lack health insurance coverage, a 15% increase between 1999-2000 and 2003-2004. Most of the increase in the uninsured is attributable to the decline in employer-sponsored insurance. The rising cost of health insurance has made it more difficult for employers to offer and individuals to afford health insurance coverage.

The NC IOM Task Force on Covering the Uninsured was part of a larger planning effort to examine options to expand health insurance coverage to the uninsured. The US Department of Health and Human Services awarded a one-year grant to the NC Department of Health and Human Services (NC DHHS) to study policy options to expand coverage to the uninsured ("State Planning Grants"). The grant was used to examine North Carolina data on the uninsured, identify policy options to expand coverage, and develop cost estimates for these policy options. The work was a collaborative effort of four different agencies and organizations: NC DHHS, NC Department of Insurance (NC DOI), the Sheps Center for Health Services Research at The University of North Carolina at Chapel Hill (Sheps Center), and the NC Institute of Medicine (NC IOM). The NC Department of Health and Human Services, through the Office of the Secretary, and the Office of Research, Demonstrations and Rural Health Development (ORDRHD), were providing the overall leadership, direction, and coordination for the State Planning Grant. The State Center for Health Statistics within the NC Department of Health and Human Services collected data in the Behavioral Risk Factor Surveillance Survey (BRFSS) about insurance coverage, access to employer-sponsored insurance, gaps in coverage, and access barriers of North Carolina residents. The Sheps Center analyzed existing data on the uninsured from national data sources and obtained data from focus groups of small and large employers, insurance agents and brokers, and the uninsured to find out more about their willingness to pay, the policy options that are most attractive, and the trade-offs that may be reasonable to make health insurance coverage more affordable. The NC Department of Insurance assisted in identifying policy options to reduce health insurance costs and to expand coverage in the private market, and the NC Department of Health and Human Services helped identify public options to expand coverage to the uninsured. Mercer Government Consulting, under contract with the Sheps Center, developed cost estimates of different cost containment options as well as different models to expand coverage. The NC IOM Task Force on Covering the Uninsured used those data to develop recommendations for ways to expand coverage.

Carmen Hooker Odom, Secretary of the NC Department of Health and Human Services, and Thomas Lambeth, Senior Fellow at the Z. Smith Reynolds Foundation co-chaired the Task Force. Also asked to participate in this endeavor were state policy makers, legislators, county commissioners, healthcare providers representatives of state healtcare trade associations, insurers, safety net organizations, small and large businesses, insurance agents, consumer advocates, and the faith community.