I spoke to Chanda Ringle, a field organizing intern at Planned Parenthood about her connections to the Affordable Care Act and its implementation. Chanda has an interesting perspective, she is both an individual who received coverage in the new health care market place and she was very involved in the enrollment effort taking place in Kalamazoo County. She said on her very first day at Planned Parenthood, before the ACA had taken effect, she was already having conversations with her colleagues about how to get people enrolled and what role Planned Parenthood could play in that process.
Planned Parenthood was very involved in getting people signed up in Kalamazoo. They had presentations about the process and enrollment events at their office. According to Chanda, many of their events had the intention of getting people motivated to try to complete the process themselves, but they found many people needed or preferred to go through the process with someone. She compared it to doing your taxes – that it was a complicated process and that many people become discouraged at first and need more support to get through the process. She and four other interns at Planned Parenthood had office hours where individuals could make an appointment to come in and get help with the process. They all ran a help line out of the Kalamazoo office for all of Michigan, and Chanda and her colleagues helped schedule appointments for people in Grand Rapids and Detroit to get assistance. They got the word out for their events by social media, developing partnerships with community organizations like The Healing Center, and by media promotion like the Channel 3 series on the ACA. They also worked closely with Enroll Michigan to advertise their event. She saw the collaboration between different organizations as a big plus in the process. It allowed for a much bigger capacity to get people enrolled. Planned Parenthood staff would help with other organizations’ events and staff from other organizations would assist with theirs. The process of organizing the collaboration was a bit difficult though because everybody at the beginning knew they wanted to help people, but they didn’t know how and what role different organizations would play.
While she thinks that the process of getting people signed up in Kalamazoo has been successful – it was not complete and the process was not without flaws. There are still a number of people who are uninsured in Kalamazoo and there were a number of issues throughout the process. She said one issues was not having enough people. She told me that even if Planned Parenthood had 10 other interns, rather than 4, doing office hours in Kalamazoo, she believe all of their appointments would have been filled. Another issue was technology. She thinks the technological issues with the marketplace at the beginning of the process were a big issue as it discouraged a lot of people who tried to sign up during the beginning period. She believes a lot of people who have never had insurance before didn’t believe that they ever would- and that they weren’t sure the passage of the ACA would change anything for them. The technological issues confirmed these individuals’ beliefs that they would never be able to get health insurance. She also expressed frustrations that when people who qualified for Healthy Michigan tried to sign up during the marketplace, they were told at the end of the process they didn’t qualify for tax credits. She said it was hard to explain to people that they would qualify for something during Healthy Michigan, but there was nothing they could do about it now. She also told the story of one man she helped sign up whose premium ended up being considerably more expensive than what it displayed in the marketplace. While they eventually got the issue sorted out, he had to pay the more expensive premium for several month, and the difference would not be refunded.
Chanda also said that she thought there were some issues in how people were trained to be an Application Counselor. All the Planned Parenthood interns had to go through a 3-4 hour in person training, and then a 10 hour online training. However, at no point did they actually go through the application step by step. Many of the interns who were doing this were very young, often college students who didn’t have a lot of experience doing taxes or dealing with insurance companies or applying for benefits. As she put it, “Insurance is really complicated. It’s really hard for someone to explain what a deducible is or any of that.” This is especially true for younger interns who barely know these things themselves. (I know I couldn’t explain to someone what a deductible was!)
Her concern with access to health care was not about people who signed up during the marketplace, but people who were signing up with Healthy Michigan. She said that people will need to see a doctor within the first 60 days of getting Medicaid or they will lose their coverage. She is concerned that doctors who do take patients with Medicaid will not have enough capacity to fit all the new Medicaid patients in, and people may run the risk of losing their new coverage.
Chanda is a student as well as an intern at Planned Parenthood, but she is older than most of the other student interns there. She is married and has three children. While her children have always had health insurance, she said that she and her husband did not have coverage until the open enrollment period. She told me that her husband had tried to apply for coverage once before but because she was pregnant at the time, he was denied even though she was not seeking coverage with him. She said that this was a symbol of how broken the insurance system was – that he was denied “for such a small dumb reason.” She seemed very happy about the fact that she and her husband now have coverage. She was positive and upbeat the entire time she was describing the effect on her family. She said to be able to see the doctor whenever she needs to, and have the visit be covered by her insurance plan will have a great positive impact on her life and her family. Perhaps because of her personal experiences, Chanda was very optimistic about the positive effect the ACA would have on our community. When I asked her if she thought that Kalamazoo would be healthier now that it was before the ACA, she responded “absolutely,” without any hesitation.