Several studies by the National Institute of Medicine conclude that a lack of insurance is hazardous to individual and community health. The Patient Protection and Affordable Care Act, signed into law in 2010, led to historic gains in health insurance coverage. A robust enrollment effort in North Carolina helped reduce the uninsured rate from about 21 percent in 2010 to a little more than 10 percent in 2017. However, from 2017-2019, federal policies eroded some of these coverage gains. In 2018, the uninsured rate in NC had climbed back to nearly 13 percent, higher than the national average. There is more work to be done to expand access to health services for the more than 1 million North Carolinians who remain uninsured, including American Indian, Black, and Latinx individuals who are less likely to have health coverage due to historic and systemic inequities.

Our goal is to increase enrollment rates in underserved areas or among groups that have been marginalized to improve access and promote the sustainability of critical health services. Additionally, COVID-19 has underscored the need for access to health coverage and other public programs (such as Pandemic EBT) that can provide relief to impacted families. The Trust will support communications, outreach and enrollment efforts that target communities with large numbers of eligible but unenrolled residents or counties with low health insurance enrollment penetration rates. The Trust is interested in proposals that include education about the upcoming Medicaid Transformation process in North Carolina and provide referrals for assistance accessing other public programs available during the pandemic.