Chapel Hill doctor becomes cheerleader for health law

Wednesday marked the first day under the law, which Congress passed in 2010, that most Americans were required to have health insurance. People who don't sign up for coverage by March 31 will have to pay a penalty on their taxes.

Dr. Sam Weir said the goals of the law will mean a lot to UNC Family Medicine Center, where about 2,000 patients – 11 to 12 percent of the clinic's total – have no insurance.

"Yes, there are problems (with enrollment), and they need to be fixed, but, my goodness, this is a huge change, and it will be a big help for a lot of my patients who are currently uninsured," said Weir, co-director of Chapel Hill clinic.

He put those thoughts in an email to the White House in October, when the HealthCare.gov enrollment website was under fire for extensive and repeated technical problems.

President Barack Obama mentioned Weir's email during a Dec. 3 speech in Washington, D.C., about the Affordable Care Act.

"It was a huge shock, huge shock," Weir said Thursday.

He acknowledged that the enrollment system is tedious. Even with UNC staff help, it takes about more than two hours to navigate the process.

UNC Family Medicine estimates only a small fraction of patients have made it through so far, but the center keeps working to increase coverage and decrease patients putting off preventive care.

"I have many patients who say, 'I'm going to postpone that. I don't think I'm going to get that mammogram' or 'I'm going to wait to get that test, doctor, because I just don't have coverage right now,'" Weir said.

In reading part of Weir's email publicly, Obama noted that the health care law will change that outlook for many Americans.

"That’s the difference that the Affordable Care Act will make for many of Dr. Weir’s patients," the president said, "because more than 100 million Americans with insurance have gained access to recommended preventive care like mammograms or colonoscopies or flu shots or contraception to help them stay healthy – at no out-of-pocket cost."

That difference doesn't work for all of Weir's uninsured patients. Some fall into the coverage gap in North Carolina, which elected not to expand Medicaid to thousands of low-income residents.

"They can't get Medicaid, and they don't qualify for subsidies because the way the law was written, and that's very unfortunate," said Tim Smith, a program research associate at UNC Family Medicine.

Weir said he expects a lot more well care visits from those who do qualify for subsidies.

"We're going to continue, I think, in the next few months to see increased demand for the services we provide," he said.

To meet demand, the clinic plans to expand. It also will hold an "enroll-a-thon" from 10 a.m. to 3 p.m. Jan. 25 to get more people signed up for coverage. For more information or an appointment, people can call Smith at 919-545-3440.