Affordable Care Act

UNC Hospital
Dave DeWitt / WUNC

Across North Carolina, health systems will again face penalties because too many patients returned to hospitals shortly after being discharged.

In fact, hospitals will pay higher penalties in 2017 than any year in history.

photo of a stethoscope
Wesley Wilson / Pexels

When the Affordable Care Act went into effect, the federal government hoped visits to the Emergency Room - some of the most expensive treatments in the industry - would decrease.

Instead, ER visits are rising. Experts blame the spike on patients who have health insurance for the first time and have yet to visit a primary care physician.

A picture of the BCBS NC Headquarters in Durham.
Jed Record /

Customers of the state's largest health insurance company who get their coverage through the Affordable Care Act might pay more in 2017.

Officials with Blue Cross and Blue Shield of North Carolina have asked state regulators for a nearly 19 percent rate increase for customers who buy coverage through

Image of children eating lunch
U.S. Department of Agriculture

A report out of Duke University says the Great Recession had a multi-year negative impact on child well-being in America.

Though the recession occurred from 2007-2009, children felt the effects from the downturn through 2012.

Blue Cross Blue Shield pen
frankieleon / Flickr Creative Commons

Enrollment errors with Blue Cross and Blue Shield created challenges for 25,000 customers. Several factors contributed to the problem including an extension to sign up for the Affordable Care Act and a software transfer within Blue Cross.

Latino child
Lillian Zepeda / Flickr Creative Commons

The Affordable Care Act (ACA) has helped close the health insurance gap for North Carolina's Latino children, according to a national report.

Ashley Hentze, left, of Lakeland, Fla., gets help signing up for the Affordable Care Act from Kristen Nash, a volunteer with Enroll America, a private, non-profit organization running a grassroots campaign to encourage people to sign up for health care, T

It's the last day to sign up for a health insurance plan under the Affordable Care Act that begins January 1.

Physician Assistant, Duke Medicine, Rural Health
Leoneda Inge

This is the Affordable Care Act’s third open enrollment season and Obama Administration officials expect at least one million more people will enroll by the end of next year. 

The increase in the country’s insured population has resulted in major growth in one profession in particular – the physician assistant. This year, Duke University is celebrating the 50th anniversary of its Physician Assistant Program, the oldest in the country.

doctor, child, health child health
Courtesy of

Child health insurance coverage in North Carolina is at a record high of nearly 95 percent, and researchers at Georgetown University say the increase is thanks to the Affordable Care Act (ACA).

A picture of a stack of cash, a stethoscope and a piggy bank. / Flickr

Open enrollment began this week for health insurance under the Affordable Care Act. North Carolinians will see some of the highest premium increases in the nation for individual and small group plans.

Blue Cross and Blue Shield will be allowed to charge an average of 32.5 percent more next year for individual plans, and six percent more for small groups. Aetna will be able to charge individual customers an average of nearly 24 percent more per month.

Doctor payoffs
Mike Licht / Flickr Creative Commons

Physicians earn their livings from patient care, but for many, fees are not their only source of income.

New data released under the Affordable Care Act shows how much individual doctors receive from pharmaceutical and medical device companies. Several physicians in the Triangle receive thousands of dollars.

Host Frank Stasio talks with Triangle Business Journal reporter Jason deBruyn about the fees and access to the data.

Blue Cross Blue Shield pen
frankieleon / Flickr Creative Commons

The Affordable Care Act was designed to give more access to healthcare at lower costs. But the state’s largest health insurer, Blue Cross Blue Shield of North Carolina, has requested a rate increase of more than 34% for patients enrolled in the ACA plans.

The company says it needs the additional revenue to offset increasing costs. The request, along with increase requests from other insurers, will be considered by the North Carolina Insurance commissioner.

Image of stethoscope
Dr. Farouk / Flickr Creative Commons

People who live in rural North Carolina are still more likely to suffer from serious health problems than their urban counterparts. Rural counties show higher rates of heart disease and obesity, and rural residents have a lower life expectancy.

The recent closures of rural hospitals around the state makes those residents even more vulnerable. Research shows that systemic problems like slow economic development and spotty insurance coverage also contribute to rural health disparities.

A picture of a dctor holding a stethoscope.
Alex Proimos / Flickr

North Carolina lawmakers have chosen to not expand Medicaid eligibility under the Affordable Care Act.

Republican state leaders, including Senate Leader Phil Berger and House Speaker Tim Moore, have said that, even if the federal government initially subsidizes new people enrolling in Medicaid, the program would eventually cost the state more than it saves.

An image of the Supreme Court
Kjetil Ree / Wikimedia Commons

The United States Supreme Court issued a decision today upholding tax subsidies under the Affordable Care Act. Chief Justice John Roberts wrote the court's opinion.

Three justices, the court's most conservative members, dissented. The decision allows 460,000 North Carolinians to continue to receive subsidies for their health insurance.

Image of tools in doctor's office
Morgan / Flickr/Creative Commons

The Affordable Care Act is still attracting big enrollment numbers in North Carolina.

Nearly 500,000 people in the state have coverage, but premiums could rise by as much as 40 percent next year for some health plans.


And the Obama administration says more than 300,000 people still are not covered because the state did not expand Medicaid. 

Dr. Richard Bock, a vascular surgeon, listens on speaker phone to another surgeon who is asking for advice before starting bypass surgery.
William Woody /

Mission Health System dominates the healthcare field in Western North Carolina, owning or partnering with six hospitals and controlling more than 40 percent of hospital beds in Western North Carolina. The nonprofit company began its expansion in the 1990s. It absorbed small rural hospitals struggling to foot the bill for an aging, low-income and underinsured population in Western North Carolina. 

On Tax Day, The State of Things talks changes in North Carolina's tax laws.
Ken Teegarden / Flickr Creative Commons

Many North Carolinians are spending April 15 finishing up their income tax statements.

But others have already noticed a few surprises on their returns due to changes in the state tax code and subsidies from the Affordable Care Act. The revisions mean higher or lower tax bills for thousands of taxpayers.

Supreme Court building, Washington, DC, USA. Front facade.

The U.S Supreme Court will take up a case this week that potentially puts half a million North Carolinians at risk of losing their subsidized health insurance through the Affordable Care Act.

In King v. Burwellthe high court will examine whether the federal government can assist in paying insurance premiums for all Americans or if it can only offer funds in states that have created their own health care exchanges.

Image of tools in doctor's office
Morgan / Flickr/Creative Commons

State health secretary Aldona Wos says North Carolina would likely need to change some of its Medicaid rules to expand the program under the Affordable Care Act. 

The health care law offered to pay for expanded Medicaid through 2016, but North Carolina was one of 24 states that rejected the expansion last year.  Gov. Pat McCrory said the state's Medicaid program was broken, and was not confident the federal government would cover the costs. 

But Wos says Medicaid is now more stable, and she plans to present the governor with options for expanding Medicaid. 

Kay Hagan and Thom Tillis shake hands after the debate at UNC-TV Wednesday night.
Mike Oniffrey / UNC-TV

  Healthcare and the Affordable Care Act (ACA) continue to be a topic of discussion on the North Carolina campaign trails. 

A picture of an elderly person's hand with an I.V. tube taped to it.
Tim Samoff / Flickr

Two Triangle hospitals will lose a portion of their Medicare reimbursements this year. They're being penalized for re-admitting too many patients within a month of hospitalization.

Under the Affordable Act, the Centers for Medicare and Medicaid Services reduce payments to hospitals which re-admit a higher number of patients than they're supposed to. They're looking at data between the summers of 2010 to 2013. Based on the number re-admissions, the CMS determines what percentage of Medicare reimbursement to withhold.

A picture of a stethoscope.
jasleen_kaur / Flickr/Creative Commons

The three-month open-enrollment period for federally subsidized health care starts in November. This year, federal funding to help people enroll in subsidized health insurance has dropped.

Sorien Schmidt works with the North Carolina chapter of Enroll America to connect people with navigator organizations. She says enrollment was a success last year, but there are still one million uninsured North Carolinians and others will need help to re-enroll.

Laptop computer
Ian Usher / Flickr

Universities across the country have made it clear that providing health coverage for temporary employees -- like adjunct professors and grad students -- is prohibitively expensive. / US Centers for Medicare and Medicaid


Two different interpretations of the Affordable Care Act have raised questions about whether some states can give out subsidies to help people pay for health insurance. 

The D.C. Circuit Court ruled yesterday that subsidies are illegal in states that did not set up their own insurance exchanges. North Carolina is one of those states. 

Then, hours later, the 4th Circuit Court said they are legal.

Host Frank Stasio talks with Duke University law professor Neil Siegel about what the rulings mean for North Carolina.