We meandered the back hallways of Ministry with Community, with Mike, to the classroom-like space, called the Candle Room, at the end of the hall. We took seats around the square of tables and, with little prompting, Mike began to tell us his experience working as a social worker at Ministry helping Ministry members enroll for health care insurance.

He started by explaining that prior to the passage of the ACA, the health plan provided for the homeless was through the Kalamazoo County Homeless Grant and the coverage was very basic. Mike explained to us that “people were left out to dry” under that system. Ministry would pay for prescriptions for select members, things the grant did not cover. He says that “the passing of the ACA will save the ministry money.” With the expansion of Medicaid in the ACA, more people are able to become enrolled and have their prescriptions paid for with their health insurance, and have access to dental and vision coverage.

Mike says most of the thirty people he has personally enrolled – not including the other thirty he has given instructions to enroll themselves – are those without any income. Mike says he has been able to enroll members when they come into Ministry looking for help with medical bills or prescription costs. They qualify for Healthy Michigan, under expanded Medicaid. With a caseload of up to thirty people per day, Mike says he makes appointments with members to enroll them on Saturdays when he also works at the day shelter.  Most of those who he enrolled were unable to do so on their own, either because of lack of access to a computer or because of computer illiteracy.  In addition, Mike has helped who are part-time Ministry employees sign-up as they do not receive health benefits.

Mike describes the biggest barrier to healthcare access: lack of knowledge about where to go to find help. This is particularly evident among those experiencing homelessness, those who have recently lost a job or home, or those who have had a significant relationship change.  It is often those persons, who are suffering from pre-existing chronic conditions, whom Ministry helps by paying for co-pays for medications or emergency hospitalizations. Now when those persons come asking for help, Mike and other Ministry social workers are able to enroll them in insurance.  With Healthy Michigan coverage, those co-pays for medication drop from around $5 to $1. These lower costs will allow Ministry to help more people with their limited monthly budget for medicines. Mike says it’s difficult to get members to volunteer to enroll, particularly those whose suspicions and distrust are raised through previous negative experiences, such as mental health, or substance abuse problems. He says that it is easiest and more effective to sign-up those with whom he and Ministry have a relationship.  Many of those helped are suffering from undiagnosed diabetes or irregular medication for mental health because, as Mike tell us, “if you don’t have insurance, you might not take your meds.”

Mike tells us, humbly and with some reserve, that he has a “passion for substance abuse and homelessness” because he “knows where they’re at”, which is why he believes “health insurance should be a right, not a privilege.”