The Affordable Care Act: The Ups, the Downs, the Final Countdown

When I accepted my position as an insurance specialist with the Philadelphia Health Corps, I signed on for a year of service helping families in South Philly insure their children through Medicaid and CHIP (Children’s Health Insurance Program). I knew being placed at the only Philadelphia Department of Public Health health center in South Philly, I would have a lot work ahead of me; but I was excited because I have a passion for youth advocacy.

A month into my service, it was clear helping insure children in the Health Centers was not where I was needed most. Yes, children need insurance, but the rollout of the Affordable Care Act Health Insurance Marketplace meant that there were thousands of Philadelphians who could now purchase private health insurance – many for the first time in their lives. My task is now to insure these individuals and families in West Philly. To be honest, being on the frontline of this historic effort is an opportunity too good to pass up.

Now, five months into the open enrollment, I have screened over 500 clients for eligibility under the Affordable Care Act and, for those eligible for tax subsidies, begun the process of purchasing insurance. Anyone who has read a newspaper or turned on the news is aware that the first weeks and months of the Health Insurance Marketplace were filled with glitches and shortcomings. Website crashes, incomplete information transfers, and application submission issues caused endless headaches for consumers and those of us tasked with helping them. But despite those issues, we forged on.

My days are filled with appointments to help people apply for and enroll in insurance. The lucky clients come in for an appointment and leave an hour later enrolled in a new health insurance plan.  Yes, when the stars align and all of the technology is working, the process could not be simpler. Unfortunately, for some individuals and families, the process is not so easy.

For some clients, the path to purchasing insurance is brimming with issues. Many follow-up appointments and applications (and re-applications) mean I come to know some clients on a first name basis. Getting to know these clients means that I am able to share in their frustration, both with the insurance process and the concerns they have over their healthcare needs. They know that when we reach the point of successful enrollment, I am thrilled for them because they finally have health insurance; but also happy (in the best way possible) that they will no longer be coming into my office for appointments.

Even with all of these challenges, I remain optimistic about the benefits of the Affordable Care Act. Throughout Philadelphia and the rest of the country, consumers are gaining access to a level of healthcare security that was previously unattainable. In these final weeks of open enrollment, the push is on to continue and even increase our strong enrollment numbers. Whether it is next week, next month, or next year, I am hopeful that all of my clients will gain health insurance so they no longer have to worry about their ability to see a doctor.
 

This post was written by PHC member Kate Waggoner.
Kate serves at the Philadelphia Department of Public Health - Ambulatory Health Services as an Insurance Specialist.