An email popped in from a woman who wanted to buy health insurance through Covered California. She was having trouble creating an account password, a process that can be difficult if you’re not into following on-screen instructions. I wanted to call her right away, as she asked, but I was home with my kids--three wild toddlers who typically don’t allow me to verbally communicate with others. I suggested that we correct the problem via email or text. She wrote back: “HERE’S A THOUGHT...HIRE MORE PEOPLE.” I replied with a short e-lecture on rudeness. She quickly answered, “EAT SHIT.” As a distinguished representative of the state of California, I maintained my professionalism and wrote back, “Your mama.”
I became a certified enrollment counselor for Covered California after 15 hours of online training. My job was to provide assistance to people looking to purchase health insurance through the exchange, or sign up for free Medi-Cal, my state’s version of Medicaid. The pay was commission only, $58 per successful enrollment. Despite the meager reimbursement, I was excited about the job. I had a decade of experience in community healthcare and was a passionate advocate and Facebook debater for the Affordable Care Act. More importantly, I figured I could make good money if I signed up just a small percentage of the 200,000 plus San Diego County residents who enrolled last year.
I developed an outreach plan in summer of 2014 for that winter’s open enrollment period. It was based on barriers to insurance enrollment that I had seen while working on similar projects: transportation, computer illiteracy, and lack of enrollment counselors available during evenings and weekends. My services would be mobile, especially since I was unable to afford a real office, and I would assist clients any time of the day or week. I’d also target places where the unemployed and underemployed tend to be during working hours, like libraries and malls and living room couches.
I had my first client within a week, a woman in her early 50s who lived in South San Diego. She found me on the Covered California website. Her husband had lost his job as an executive in the defense industry and she needed help figuring out this “Obamacare thing.” I had learned in training to never say Obamacare, and had received a stern follow-up email telling me to scrub the term from my website. “Sure, I can answer questions about the Affordable Care Act,” I said. I drove to her house that same day.
I walked on to the client’s porch and saw what I was hoping to avoid: a damn dog. He jumped and barked and looked like he wanted to start some shit. The client called us both inside and told me to have a seat. She asked if I wanted something to eat or drink. I refused. According to Covered California rules, I was not to accept any sort of payment or gift from enrollees. But my mouth was dry from nervousness, so I changed my mind, “Mind if I have some water?”
I hurried through my spiel: “Open enrollment has yet to start, so your premium would be based on the current year’s income. If your family’s employment situation does not change in the near future you’ll qualify for Medi-Cal. Whatever the case, you’re likely find a much better deal on the exchange than you would by accepting COBRA from your husband’s former employer...”
The woman scoffed at Medi-Cal. “As I much as I don’t like going to the doctor, I want to keep the one I have,” she said. I collected her personal information as we made our way through the application, filtering through tangents about politics and personal finance. “If my husband doesn’t find a job that pays as much as his last, we’ll lose the house and I’m not sure if he can at his age.” It was a spacious, elegant house that I could buy if I enrolled about 17,000 people for Obamacare. I had little to say besides “Sorry to hear that” and later, a very corny, “It gets better.”
We took an hour to complete an insurance application that should have taken 30 minutes. The client chose a health plan that cost around $400 a month. Despite the price I think she felt a bit better by the time I left. The dog did, too. He didn’t even bother to look as I hurried past. I received an email from the woman days later. Her husband had a big interview coming up.