Dec. 12, 2013

While it’s undeniable that the launch of Obamacare’s healthcare.gov website had its initial technical shortcomings, states that have refused to set up insurance exchanges and expand Medicaid coverage could pose even bigger problems for health care coverage in the U.S. in the long term.

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Dr. Jon Oberlander

That is the sentiment expressed in an opinion piece appearing in The New England Journal of Medicine, written by two faculty members from The University of North Carolina at Chapel Hill.

The article, “Implementing Obamacare in a Red State — Dispatch from North Carolina,” co-authored by Jon Oberlander, PhD, and Krista M. Perreira, PhD, affords their view of how the Affordable Care Act (ACA), popularly known as “Obamacare,” has been rolled out in North Carolina since the law’s mandated health care insurance exchanges went live in October. North Carolina is one of the 27 states that passed legislation rejecting the option to establish a statewide health insurance exchange, instead opting to let residents use the federal exchange to gain access to the new government insurance exchanges.

Oberlander is professor of social medicine in the UNC School of Medicine and of health policy and management in UNC’s Gillings School of Global Public Health. He comments widely in the media about health care policy, particularly about the ACA. Perreira is associate dean of UNC’s Office of Undergraduate Research, professor of Public Policy in the College of Arts and Sciences, and adjunct professor of health behavior, health policy and management, and maternal and child health in the Gillings School. She also is faculty fellow at the Carolina Population Center, where she leads a Robert Wood Johnson Foundation-funded project to implement health care reform for immigrant populations.

The states that eschewed establishing their own exchanges also turned down expanded Medicaid funding. Oberlander and Perreira, both advocates of Obamacare, discuss their observations on how access to health care in North Carolina has been affected in recent months by the state’s decision to rely on the federal system. They also project potential implications in the state that this decision will have during the next few years.

The full article is available on The New England Journal of Medicine website.


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Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu

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