Faces of the Newly Insured

Twelve years ago, I traveled around the country meeting individuals and families who were scraping by without health insurance. In 2015 I returned to the communities I had visited more than a decade earlier. I wanted to learn how the people I had met were faring in the era of the Affordable Care Act (ACA or “Obamacare”). Working with videographer Adam Cohen, and with the support of the Commonwealth Fund, I helped prepare a series of video essays with five newly insured Illinois residents.

When I first met the people featured in the videos, all were stuck in spirals of deteriorating health, low-wage employment and medical debt, with no obvious way forward.

Photograph by Adam Cohen.
Photograph by Adam Cohen.

Taneila was a college student with diabetes who was supporting herself with a part-time job. When she turned eighteen she was no longer eligible to remain on her parents’ health insurance, and as a part-time worker she was not eligible for insurance from her employer.

 

Photograph by Adam Cohen.
Photograph by Adam Cohen.

Cindy, a young mother, had left the workforce to care full-time for her special needs baby. Her husband’s employer did not offer affordable insurance to “dependents.”

Laura was working in the hotel industry, notorious for not providing health insurance for employees.

Joyce was working on and off as a nursing home aide and her husband, Marcellus, was working full time in a warehouse. Neither had ever been offered insurance by an employer and both were experiencing serious health challenges as a result of the heavy lifting required in their jobs.

Photograph by Adam Cohen.
Photograph by Adam Cohen.

All five people had applied for Medicaid but earned too much to qualify for assistance under the old (pre-ACA) eligibility thresholds that limited coverage to low-income parents and severely disabled adults.

Post-ACA all now are insured.

Taneila now has a factory job that provides health insurance benefits. She wishes that when she had turned 18 she could have remained on her parents’ coverage like young people until age 26 now can under the ACA rules. If she had been able to stay on their insurance, she believes, she would have finished college and would now have a better job than working in the factory.

Photograph by Adam Cohen.
Photograph by Adam Cohen.

Cindy continues to cycle on and off coverage with her seasonal job in the local school system, but at least she has insurance for most of the year, which has allowed her to manage her chronic health challenge and maintain a good level of health.

Marcellus became sufficiently disabled (as a consequence of poor working conditions in his jobs and poor access to healthcare) to qualify for Social Security Disability. As a consequence, he is now insured through both Medicare and Medicaid.

The ACA was crafted to include federal funding for expanding Medicaid eligibility for more Americans. However, the Supreme Court ruled that Medicaid expansion must be optional for states. In Illinois, like in other states that chose to expand Medicaid, there have been substantial drops in the numbers of uninsured residents. Joyce and Laura, both of whom work part-time, are now covered by Medicaid. (In contrast, most of the people I caught up with in Texas, Mississippi, and Idaho—states that so far have declined the Medicaid expansion—are still uninsured.)

You can access the videos here: http://features.commonwealthfund.org/faces-of-the-newly-insured

I encourage you to hear their stories!

 

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