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“I’ve been in the North Carolina workforce since 1973, I’ve been <br />paying taxes for 44 years” said Ruffner who employs four other <br />people in her medical case management firm, Navigate NC. “I <br />work. I pay taxes. I own small business and I’m helping others to <br />work and pay taxes.” <br />She said when she worked for someone else, she got insurance through her job. And <br />when she started Navigate NC in 2014, she got a subsidy t hrough the ACA insurance <br />marketplace. <br />But starting a small business often means being the last person to get paid, and some <br />years the pay is less than in others. <br />“I’m pouring 100 percent of my income back into the company during its early years and <br />I received no salary,” she said. “This enrollment year I could not honestly vouch that I <br />would make the threshold of income necessary to qualify for a subsidy. <br />“I would not lie in order to make that income threshold.” <br />Erica Pettigrew said it’s common to see uninsured patients who are health care <br />workers. <br />Pettigrew, who serves as the medical director at the Orange County Health Department, <br />told the story of a patient, who worked for 35 years as a medical assistant. Now the <br />woman works as a personal health aide, a job that comes without insurance. <br />When she came in to see Pettigrew for care at the health department recently, she had <br />a suspicious lump in her throat. <br />“She really needed to see an ear, nose and throat specialist but she doesn’t have <br />coverage and there was nothing I could do,” Pettigrew said. “This woman had devoted <br />her career to helping others and yet she does not have access to affordable health care <br />and she is not going to be able to get potentially life-saving treatment.” <br />Dr. Erica Pettigrew told people at the General Assembly about how she frequently treats <br />patients who work as caregivers, yet have no insurance of their own. Behind her, <br />Duffner looks on. Photo credit: Rose Hoban <br />Pettigrew said these situations are frustrating. <br />“Words cannot express what it feels like as a physician to see a patient possibly dying <br />before your eyes and not able to get the care that she needs simply because she does <br />not have health care coverage,” she said.