“The uninsured aren’t always the poor; it’s a lot of small-business owners and professionals.”

Dr. Raymond Higbea has been involved in public health education and action for

years; he has taught all of the health care administration courses at WMU for the past

five years, and before that taught at Cornerstone University for two years. Dr. Higbea’s

doctoral research addressed access to health care by the uninsured, and he has

been involved in this issue for over 10 years. Dr. Higbea joined the Enroll Kalamazoo

Community Outreach initiative (as well as a coalition based in Calhoun County) and

became involved in organizing official enrollment events in both counties.

Of the planning and execution of the Kalamazoo enrollment events themselves,

Dr. Higbea said they appeared to be on the whole successful. “The biggest issues were

the computer issues,” he said. Dr. Highbea estimated that at least 1,000 people were

brought into the enrollment events and successfully signed up for health insurance.

And while a possible 11,000 more uninsured residents remain eligible in Kalamazoo for

insurance under the ACA, Dr. Higbea believes that managing to recruit that number of

people at these events was a big achievement, as, in his opinion, “Enroll America and

Enroll Michigan did little” in actually bringing people to register. The success came from

the local level, according to Dr. Higbea.


Juxtaposing the apparent success of the enrollment events, however, was Dr.

Higbea’s attitude concerning the actual effects the ACA is going to have on increasing

access to health care. In his opinion, no real net increase in access to care will actually

be achieved through the ACA, as “the uninsured aren’t always the poor; it’s a lot of

small-business owners and professionals.” In Dr. Higbea’s view, the majority of those

who are actually gaining health care through the ACA are people who had been

enrolled in a health insurance plan before, but had decided to give it up due to high

premiums. Therefore, the people who are “newly insured” under the ACA are those

who still could afford health care before, but simply had co-pays and premiums that

were too high to make it worth paying for health insurance each month. He cited the

immense success of the Portage, Michigan enrollment event as an example of this

phenomenon, as the majority of those attending were part of the middle class — in other

words, people whose main cause for celebration was not the possibility of accessing

health care, but at doing so at a lower price than before. For a great proportion of those

who make too much to qualify for Medicaid but are still struggling economically, Dr.

Higbea feels the ACA is not truly helping them to gain access to health care, as cost

“barriers [like]… the copays and deductibles” will most likely cause them to decline

enrollment or drop out of their new insurance plans.


While Dr. Higbea was skeptical as to the extent the ACA has had thus far on

increasing access to health care, he did seem to believe that the country is on a positive

trajectory concerning health and health care thanks to the new law. While public

opinion concerning the ACA is still fairly negative, he feels that “the sentiment is turning

from ‘repeal and replace’ to ‘repair.’” However bumpy the implementation of the ACA

has been, Dr. Higbea believes that this more universal approach at increasing access to

health services cannot simply be dissipated by policy makers in the future. As he

concluded, “the framework [for a better health system] is there.”

Leave a Reply

Your email address will not be published. Required fields are marked *

− one = 5