Meet The Health Care First-Timers

Originally published on January 15, 2014 7:44 pm
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Millions more Americans now have health insurance under the Affordable Care Act. Much of the focus has been on coverage gaps, increased premiums and the clumsy rollout of the new law. But 6.1 million Americans, many of whom would not otherwise have health insurance, are now enrolled.

NPR's Nathan Rott has been talking with some of them.


NATHAN ROTT, BYLINE: The waiting room at St. John's Well Child and Family Center in South Los Angeles is packed. So packed that Tanya English is having a hard time finding her daughter.

TANYA ENGLISH: Oh, right here. Oh.

ROTT: Tanya's daughter, Charlize, is nine months pregnant. She's here for an ultrasound and a check up, and she's all smiles as she walks back to an examination room because this visit is covered. For a number of years, Charlize didn't have health insurance.

CHARLIZE: And now that I got it, I could just walk into a doctor's office without a problem.

ROTT: Her timing was right. Under the Affordable Care Act and the expansion of Medicaid, she was able to get insurance just weeks before her due date. Nearly 2.2 million people have now enrolled in regular health insurance plans through Obamacare nationwide. Another 3.9 million, like Charlize, have been deemed eligible through Medicaid expansions. And there's a lot of them at this health center.

ALEXIS GOMEZ: This is one. On 2001, he was working in a moving company.

ROTT: Alexis Gomez is a physician at the clinic. His patient, Juan Salvadia, has a long history of heart problems and a pacemaker. This is his first check up in a while.

How long has it been since the pacemaker was checked?

GOMEZ: When was the last time that they (foreign language spoken)

JUAN SALVADIA: (Foreign language spoken)

GOMEZ: Last year or like a year ago.

ROTT: Is that a pretty long time to...

GOMEZ: It's a pretty long time, yeah.

ROTT: Gomez says he's seen a lot of cases like this in the last two weeks - newly insured people coming in for check-ups that are long overdue with prescriptions that haven't been filled or with diseases that have gone unmonitored. And then there's the newly insured that have just never been checked at all.

GOMEZ: At least four or five a day came here, totally asymptomatic, first time, never seen a doctor. Now, they come here and guess what - diabetes, hypertension show up.

JIM MANGIA: We did a lot of work to prepare for the roll out of the Affordable Care Act, and it's way exceeded what I expected.

ROTT: This is Jim Mangia, the St. John's Well Child and Family Center CEO.

MANGIA: At one of our sites on Saturday, we had 36 people walk in that didn't have appointments, all of whom were newly insured that wanted to see a doctor for the first time.

ROTT: Mangia says part of that is due to their location. The center estimates that one in three people in south L.A. are or were uninsured. Groups like SEIU United Healthcare Workers West have worked to sign those people up. Dave Regan is the group's president.

DAVE REGAN: For every example of a problem, a glitch, there are now over a million people in California whose lives are fundamentally changed.

ROTT: And it isn't just low-income people that are experiencing that change. And it's certainly not limited to California.

AMANDA SHELLEY: My name is Amanda Shelley. I live just outside of Phoenix in Gilbert, Arizona. And I'm a physician assistant.

ROTT: Shelley didn't have health insurance either.

SHELLEY: I was not one of the poor people that people think are signing up for Obamacare. I was - I'm one of the well-off people.

ROTT: But she was unable to get insurance because of pre-existing conditions. That changed January 1st. Then...

SHELLEY: On January 3rd, I started having some pain in my abdomen.

ROTT: A piercing, stabbing pain.

SHELLEY: And I tried to ignore it because I'm used to ignoring things because I didn't have insurance.

ROTT: But by the next day, it was so bad that she had to go in. She called first to make sure that she really was covered.

SHELLEY: And two days later, I had my gallbladder out, urgently.

ROTT: She says without insurance...

SHELLEY: This would've been bankruptcy for me, definitely.

ROTT: So even though Amanda Shelley knows the new law isn't perfect, for her, it's already proved its worth. Nathan Rott, NPR News. Transcript provided by NPR, Copyright NPR.