Guest blogger, Vicki Hansen, ACSW
The enrollment period for the ACA Marketplace ended on December 16, 2017. For 6 weeks I volunteered as an enrollment specialist to help consumers apply, renew, or adjust their Marketplace insurance plans.
A lot has happened politically since I retired as executive director of the Texas Chapter of the National Association of Social Workers in 2014. During my nearly 20 years there, I worked on public policies that included healthcare. Social workers have long been involved in helping to shape healthcare policy and it is essential that we continue. Watching what was happening to the ACA and to CHIP under the current administration made it impossible for me to do nothing. I wanted to get back into the trenches and see the people who were being affected; I wanted to help people get the health care services they needed – I wanted to get back in the field.
I received 40 hours of training provided through the amazing nonprofit Foundation Communities. I shadowed an experienced person (also volunteer) for a few hours and then I started enrolling people on my own. I’ve rarely felt so incompetent …by the time the 6 weeks was over I was chomping at the bit to do this again next year.
The array of situations that caused people to need low cost healthcare was both expected and surprising. Citizenship is required to be eligible so everyone I worked with was either born here or a naturalized citizen. Most of the people who came in were worried or angry, but mostly grateful. I’ll share a few of their stories –
Many of the clients I had were musicians - important to the economy in Austin, but are generally self-employed with no benefits. They generally seem to earn between $11,000 and $30,000 a year. Between the ACA tax credits and various public and private partnerships, they pay anywhere from $25 -$100.00 a month - everything else is underwritten. They were SO grateful and appreciative. It was a great experience. Another client works as a dishwasher for a restaurant. He is an older man who earns about $900 a month with no benefits. His wife is ill and cannot work. He also, was so grateful for the ACA. One of the most challenging clients was a white man in his late thirties. He works 3 jobs to make ends meet and was very angry about the dramatic increase in his premiums from last year and the direction of the country. It was hard not to engage in his rage.
Most of the people I worked with work part-time with no benefits. Ride – sharing, music, photography, restaurant work, hair stylists and landscapers. They were generally people who had little control over how much they worked and were never offered benefits. Some of them are HIV positive, some of them have Type I diabetes. One person is a kidney transplant recipient – his wife was his donor. He is a blue collar worker who will be on expensive medications the rest of his life.
For many of the people I met during this process, I am simply worried about their future. I will continue to be in touch with my legislators and continue to advocate for change. I hope you will do the same.
Will Francis, LMSW
Government Relations Director,
National Association of Social Workers,
Cossy Hough, LCSW
Clinical Assistant Professor, The University of Texas at Austin,
School of Social Work
Anna Stelter, LMSW, MPH
Health Policy Analyst
Texas Health Institute
Alison Mohr Boleware, MSSW
Mental Health Policy,