What I Learned by Helping People Sign-up at HealthCare.gov

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What I Learned by Helping People Sign-up at HealthCare.gov

February 2019

Annie Henson

By Annie Henson (@anniethenson)
Center for Health and Social Policy Ambassador

From November 1st until mid-December, I can’t quite recall how many times I was greeted by this page as I sat in front of a computer in my little corner of a little cubicle at the Foundation Communities office. Sitting next to me as I clicked through this website was a rotating cast of the Austinites: a musician, a recent college graduate, a family of three. My company was different each hour, but they all shared a need.

Each person who sat in the waiting area, for up to a couple hours, and then next to me by that computer, was hoping to walk out of the door with health insurance plan for the coming year. I was there to help them decipher the ever-complicated enrollment process and translate the fine print and multitude of options into a language they could relate to.

For a bit more background on why I set aside my readings and problem sets to volunteer my time:

  1. Health insurance coverage is not an area that Texas does very well in. Actually, Texas has the highest uninsurance rate of any state, 19% of Texans under 65 were uninsured in 2018. That’s 4.7 million Texans without health insurance.
  2. Texas exchange enrollment in 2018 was down 8% from 2017 and 13.7% since 2016.
  3. Our high rate of uninsurance hurts Texans and the Texas economy. Those who are uninsured are four times less likely to have a regular healthcare provider and the lower lifetime earnings and worse health of uninsured Texans costs the state $57 billion.

It was those kind of statistics, and my interest in public health, that led me to volunteer as a Certified Application Counselor with Foundation Communities’ Insure Central Texas program.

The part of my role that proved to be the most impactful for me was the relationship I would build with the clients. Maybe I was just sitting with the client for an hour or so, but we talked about the kinds of personal information hardly ever comes up with even my closest friends. Through the enrollment process, the boundaries around the cultural taboos of income and medical history were dissolved. In order for us to work together they had to trust me with that information, which is telling of how deep the desire for health coverage is for so many Texans. With their information and trust, I was tasked with bringing in my knowledge of the system, and together we could find a plan that fit their needs and priorities.

Easy enough, right? No not really. Though each client I sat next to signed up for a plan, there were few that did so without a thoughtful deliberation of their priorities, cost versus coverage. With that decision there was always a compromise. That part of the process made me feel helpless. For a believer that health care is a right, watching coverage lose to cost, almost every time, was heartbreaking.

That heartbreaking feeling left me with a motivation to better understand and change the system; which was only going to come with putting down the problem sets and getting to know the healthcare system in this intimate way. For any LBJ student looking to know the system, or anyone who shares my concern about Texas’ uninsured rate, I’ll be volunteering again for the 2020 open enrollment, join me!


Annie Henson is a 2018-2019 CHASP Ambassador in the second year of a dual-master degree program, pursuing a Master of Public Affairs at the LBJ School of Public Affairs and a Master of Public Health at the UT Health Science Center - Austin Regional Campus. Annie is particularly interested in expanding her understanding of the systems that impact health disparities, especially in regard to nutrition and women's health. She hopes to leverage the set of skills granted through the dual-degree program to work at the intersection of social policy and program implementation. She is also very interested in program evaluation within the philanthropic sector or in support of public/private partnerships.

More about the Center for Health and Social Policy Ambassador Program.

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The views, information, or opinions expressed by blog contributors are solely those of the individual authors and do not necessarily represent those of the Center for Health and Social Policy, the LBJ School of Public Affairs, or The University of Texas at Austin or affiliated employees.