An interview with Melinda Nichols, a certified application counselor, who works at Bronson Methodist Hospital as a financial advocate.

Melinda believes that the population that she works with is not of a particular demographic. Because Bronson is a trauma center, there are people from as far as Kent County and Wayne County. She sees roughly forty patients a week, but this is a very general estimate. Within the first week of Healthy Michigan, she estimates that they completed sixty applications. This means that with the arrival of Healthy Michigan, Melinda has seen an increase in workload. Melinda graduated with both a bachelor’s and master’s degree in social work. Prior to this position, Melinda worked in patient registration.

It is difficult when people fall in the middle: they do not qualify for Medicaid, but cannot afford the plans on the exchange. Although everyone who comes into the Bronson emergency room is treated, people without good insurance oftentimes have to file bankruptcy because they cannot pay their medical bills. Any person admitted to the hospital that is listed as having no health insurance meets with Melinda. In her capacity as a financial advocate, Melinda sees “the self pay population that’s admitted to the facility, complete[s] Medicaid applications, or do[es] the Affordable Care Act enrollment when it was the enrollment period”. Bronson helped with signing people up through the enroll events, many of which Melinda attended. However, she could not initially help enroll people because she was not yet certified as an enrollment counselor.

Melinda believes that the landscape of her profession has the potential to change. The biggest positive changes will be for those who have insurance for the first time. She thinks the Affordable Care Act “will get the healthcare they need and deserve”. Patients will have better access to medications, which in turn will prevent inappropriate hospital visits. Despite these exciting new developments, Melinda says, “there are still some quirks that need to be worked out”.  Because the Affordable Care Act and Healthy Michigan just started though, she is optimistic for the future.

Melinda is passionate about her position and really helps her clients with the process of finding the funding for healthcare if they are eligible for any government assistance. It is difficult to work with patients because they are often ill and emotionally drained when completing the paper work. She also does follow-up with her patients to let them know if they were approved or not. Even if a patient does not meet the criteria for government assistance, sometimes Bronson financially helps the patient.

When asked about patients’ reactions to the Affordable Care Act, Melinda says that there is a big mixture of opinions. Some patients are excited about the reduced premiums they have to pay each month. However, for others health insurance costs rose or they are disappointed that they have to purchase insurance. She often has to tell patients that there is a difference between wants and needs, and that while health insurance puts a dent on one’s monthly budget, it is necessary. There are also patients who did not realize that they had to enroll for coverage by March 31^st that are still without insurance.