That fine was insult to injury for those who didn’t have and couldn’t afford coverage in the first place, and left them none the richer and still without coverage.

Since its enactment, however, Obamacare has always offered so-called “hardship exemptions” that help people like the homeless, victims of domestic violence or even people who have received a utility shutoff notice avoid the fine. 

Thanks to a series of actions initiated by President Donald Trump over the course of 2017, now most everyone in Haywood County and in Western North Carolina may qualify for a rebate if they paid a fine. 

“What happened around this time last year was Centers for Medicaid Services released some new exemptions,” said Vicki Gribble, a health care navigator for Mountain Projects.  

Paramount among them is the “lack of choice” exemption — if only one insurance company offered coverage in a county, residents can now apply for an exemption, file an amended tax return, and get their money back. 

“In 2017, we only had one insurance company come out to our county, Blue Cross/Blue Shield,” she said. “People had no choice because there was a lack of competition.”

Gribble’s usual duties as a navigator include helping people sign up for health care coverage, but over the past few months, she’s been rather busy helping people file for the exemption. 

Just last week, for example, Gribble filled out 114 hardship exemption applications that, if approved, would bring more than $165,000 in penalty fees back to Haywood County residents. 

For 2017, the Obamacare fine was $695 per adult, or 2.5 percent of household income, whichever is greater. For children, the fine was $347.50, half the adult rate. The maximum fine a family would pay was $2,085.

Mountain Projects navigators are available in the seven westernmost counties of North Carolina — Cherokee, Clay, Graham, Haywood, Jackson, Macon and Swain — and have been since the program began six years ago, because most residents of those counties are also eligible for the lack of choice exemption and many face challenges related to internet connectivity, lack of public transportation and poverty issues that make smartphones a luxury and applying for the exemption onerous. 

“We’ve brought back $1 million this year — at least — in the seven western counties,” said Jan Plummer, navigator program coordinator at Mountain Projects. “It’s a really short appointment, maybe 15 minutes.”

It is now too late to request exemptions for the year 2015, but people can still file an exemption for 2016 as long as they do so before Dec. 31, 2018. Exemptions are still available for 2017 and are also available for this year’s tax filings, but come January 1, 2019, the fine will no longer be assessed — the result of a Trump tax bill last fall — so the exemptions won’t be necessary. 

The 2019 fine’s elimination comes as a result of the failed effort to repeal Obamacare, but in essence still undermines the program substantially; when people who don’t pay into the system aren’t penalized, there’s less incentive for them to pay into the system, which then suffers diminished membership and bargaining power.

One happy consequence of the lack of choice exemption, though, is that by definition the people Gribble and other Mountain Projects navigators shepherd through the process are, by definition, without coverage. 

“So many people who have not had health insurance have connected with us at Mountain Projects, but we’re trying to look at their whole health,” Gribble said. “We want to get them connected to other health care.”

The navigator program in the seven western counties is funded through a federal grant that comes through CMS and ends Sept. 12.

“We’re anxiously waiting for our funding announcement to come through on the 12th,” said Plummer, who noted that it costs about $350,000 or so for four full-time and three part-time staffers to cover the seven western counties.

In July, CMS announced that funding for the navigator program nationally would be cut from $36 million this year to $10 million next year. North Carolina’s share of that funding is expected to drop from $3.4 million to $500,000. 

Are you eligible?

To find out whether you or someone you know is eligible for an exemption from Obamacare fines paid in the past or anticipated for this year, visit www.healthcare.gov/health-coverage-exemptions or call Mountain Projects Waynesville office at 828.452.1447.